Relating to prescription drug affordability, including the creation of a prescription drug affordability board

This bill relates to prescription drug affordability measures, including the creation of a prescription drug affordability board. The bill provides definitions used in the bill. The bill creates the prescription drug affordability board (board) for the purpose of protecting stakeholders within the health care system from the high costs of prescription drug products (product or products). The bill provides for the membership and functioning of the board; the hiring of an executive director and other staff for the board; salaries, per diems, and reimbursement of expenses of the executive director, general counsel, staff, and members; and other provisions that apply to the meetings of the board. The board shall meet in open session at least four times annually to review product information, and may meet in closed session to discuss proprietary data and information. The board shall provide public notice of each board meeting at least two weeks in advance of the meeting, make materials for each meeting available to the public in advance of the meeting, provide an opportunity for public comment at each open meeting of the board, and provide the opportunity for the public to submit written comments on pending decisions of the board. The board may allow expert testimony at its meetings, including when the board meets in closed session. Members of the board shall recuse themselves from decisions related to products if the member, or an immediate family member of the member, has received or could receive certain financial benefits from the work of the board. The bill provides for disclosure of conflicts of interest relative to the work of the board, and prohibits the members of the board, the executive director, the general counsel, board staff, and third-party contractors from accepting certain gifts or donations. The bill provides that, to the extent practicable, the board shall access pricing information for products through various means including by entering into memoranda of understanding with another state to which manufacturers already report pricing information; assessing spending for prescription drugs in this state; and accessing other available pricing information based on state reporting and transparency requirements. The board may enter into a contract with a qualified, independent third party for any service necessary to carry out the powers and duties of the board, and shall adopt rules to administer the bill. The bill requires the board to create a prescription drug affordability stakeholder council (council) to assist the board in making decisions. The council shall consist of members including manufacturers of brand-name and generic prescription drugs, providers that dispense or administer prescription drugs, prescription drug suppliers, and consumers of prescription drugs. Members are appointed by the majority leader of the senate, the minority leader of the senate, the speaker of the house of representatives, the minority leader of the house of representatives, and the governor. The members of the council shall have knowledge in certain areas as specified in the bill. The bill provides for the annual selection of a chairperson and co-chairperson, terms, and reimbursement of actual and necessary expenses of the members. The board is required to identify certain brand-name drugs or biologics, biosimilars, generic drugs, and other products that may create affordability challenges for the state health care system and for patients, including drugs used to address public health emergencies. After identifying the products, the board shall determine whether to conduct an affordability review by seeking council input about the product and considering the average patient cost share of the product. The bill specifies relevant information that may be included in conducting an affordability review. If the board finds that the spending on a product reviewed has led or will lead to an affordability challenge, the board shall submit a report to the general assembly of the board’s findings, including a recommended upper payment limit. The upper pay limit for the product shall be determined by considering the cost of administering the product, the cost of delivering the product to consumers, and other relevant administrative costs related to the product. Any information submitted to the board in accordance with the bill is subject to public inspection only to the extent provided under the state’s open records law. The bill requires the board, on or before December 31, 2024, and annually thereafter, to submit to the general assembly a report that includes price trends for products in the state; and any recommendations regarding further legislation needed to improve prescription drug affordability in the state. On or before July 1, 2025, the board shall submit a report to the general assembly on the operation of the generic drug market in the United States that considers the prices of generic drugs on a year-over-year basis, the degree to which generic drug prices affect yearly insurance premium changes, annual changes in insurance cost-sharing for generic drugs, the potential for and history of drug shortages, the degree to which generic drug prices affect yearly state Medicaid spending, and any other relevant issues.