At its July 31 meeting, the Minnesota PDAB reframed its six selection criteria as ranking elements meant to inform Board judgment, not dictate which drugs must be reviewed. The Board favored a first-round “Goldilocks” list of roughly 1,300 NDCs drawn from Minnesota’s 62J statutory drug list, Medicare Maximum Fair Price drugs, and drugs recommended by patients and the public. The list was submitted to IQVIA for a data-cost quote, with Medi-Span pricing also under consideration. Additional drugs raised by Board members or through outreach such as Farmfest may be added if data acquisition is feasible, or carried forward into a later review round.

One important methodological issue also surfaced: NDCs may be the right level for populating data, but not necessarily the right unit for selecting a drug for review. Discussion also pointed to CMS’s approach of grouping the NDCs associated with a molecule, warning that reviewing a single NDC could fragment the analysis or create an easy workaround when the same drug has multiple strengths, package sizes, or formulations.

At the Aug 10th meeting, the Board debated how its mandate should be measured: by use of its statutory tools, including UPLs, or by demonstrated affordability results. Members noted that the Legislature granted UPL authority without requiring its use, while others argued that creating a Board with full UPL enforcement authority signals an expectation for movement in that direction. The discussion also raised a broader test of effectiveness: cost reviews or UPL actions that don’t improve affordability may still leave the Board short of its purpose.

The Board sharply debated whether success should be measured by action or by outcome. Some board members argued that the statute’s end is protection from unaffordable drug costs, not use of any particular tool. He gave the hypothetical that if prices fell 35% because manufacturers responded to the threat of Board action, the PDAB could still have succeeded even without taking formal action. Other board members emphasized that the Board has a defined statutory lane and specific tools, while others said it will likely still be judged on whether it actually advances cost reviews and affordability determinations.

Patient and Stakeholder Engagement: Virtual, evening event week of October 12th