Prescription Drug Affordability Boards (PDABs) Action Center
With PDABs becoming increasingly advanced throughout the country, HealthHIV is advocating for the crucial needs of patients amid rapid policy change and critical conversations happening on this subject.
HealthHIV seeks to:
- Protect access to lifesaving medications
- Push forward and uplift initiatives to ensure equitable medication uptake
- Preserve critical public health efforts
- Promote the patient voice in all healthcare policy discussions
Related Resources
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Joint Statement and Public Comments on the Proposed Changes to Connecticut’s Medicaid Protected Drug Classes
ADAP Advocacy and HealthHIV issued the following joint statement in response to the proposed changes to services for People Living with HIV/AIDS (PLWHA) under Medicaid as set forth in the Connecticut Governor’s Health and Human Services budget recommendations.
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MAPRx Recent Medicare Part D Changes, September 2025
This infographic from MAPRx describes Medicare Part D changes that may help with out of pocket costs.
PDABs by State
Learning from Other States: States considering starting their own PDABs may look to the experiences of others, such as Colorado, Washington, Oregon, and Maryland, to learn from their approaches, challenges, and successes. This can help tailor policies to address their healthcare systems’ and patient populations’ specific needs and circumstances.
- Engagement and Transparency: All these states are showing varying levels of commitment to engaging with stakeholders, particularly patients, to ensure that the policies developed are reflective of community needs and real-world impacts.
- Legislative Progress and Challenges: Each state is at a different stage in their legislative process concerning drug affordability.
- Patient-Centric Focus: There’s a clear trend towards ensuring that any drug pricing or affordability measures consider the unique needs and circumstances of patients, aiming to prevent negative impacts on access to necessary treatments.
- Discussion Points: Similar to Oregon, discussions in Colorado also touched upon concerns related to fear and anxiety among patients regarding access to medications under the potential upper payment limit (UPL) settings.
- Patient and Public Engagement: Efforts are being made to engage more directly with patients and public stakeholders to better incorporate their inputs into the decision-making process.
- Expansion of UPL Process: The UPL process is being expanded with more opportunities for stakeholder input scheduled through December.
- Advisory Role Development: Plans to recruit advisors over the summer to help refine processes and perhaps include patient representatives directly in the advisory process.
- Board Website: https://doi.colorado.gov/insurance-products/health-insurance/prescription-drug-affordability-review-board
- Advisory Group Website: https://doi.colorado.gov/insurance-products/health-insurance/prescription-drug-affordability-review-board
- Initial Review Approval: Maryland approved an initial review of certain drugs, with a focus on ensuring therapeutic alternatives are considered. They are particularly aware of the heterogeneity of diseases and the unique needs of patients.
- Stakeholder Engagement: The state is actively inviting feedback on why substituting therapeutic alternatives could be problematic, highlighting an openness to understanding patient-specific treatment needs.
- Board Website: https://pdab.maryland.gov/Pages/default.aspx
- Prescription Drug Affordability Stakeholder Council (PDASC) Website: https://pdab.maryland.gov/Pages/stakeholder-council.aspx
- Issues Encountered: The PDAB in Oregon experienced unprofessional behavior and pressure, highlighted during a meeting where there was a notable “rant” by a board member. This incident reflects the board’s stress due to the lack of public engagement, as town hall meetings were poorly attended and had minimal patient input.
- Response to Public Input: Despite efforts to facilitate participation, such as providing translators, the PDAB seems up against significant challenges in obtaining meaningful public and patient input.
- Early Stages of Process: Washington is earlier in the process compared to other states. There’s a focus on involving patient organizations and caregivers in developing the process, surveys, and outreach strategies.
- Future Engagement Opportunities: The state plans to include patient representatives in advisory panels, signaling a commitment to including patient voices in decision-making processes related to drug pricing.
- Board Website: https://dfr.oregon.gov/pdab/pages/index.aspx
- Advisory Group Website: https://www.hca.wa.gov/about-hca/programs-and-initiatives/clinical-collaboration-and-initiatives/prescription-drug-affordability-board
- Engagement Necessity: State experiences highlight the necessity of engaging more effectively with the public and especially with patients to ensure that the PDAB processes are inclusive and reflect real-world impacts and concerns.
- Transparency and Education: There is a significant need for transparent processes and educational outreach to ensure that stakeholders, particularly patients, understand what UPLs entail and how they might affect access to necessary medications.
