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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.

The Action Center helps:

  • 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.

What is a Prescription Drug Affordability Board (PDAB)?

PDABs — sometimes known as Review Boards, Affordability Councils, or other variations — are oversight entities established by states to evaluate and manage the costs of prescription drugs. Their primary objective is to ensure drug affordability for consumers while balancing state healthcare budgets. PDABs conduct “affordability reviews” of drug prices and spending, and develop strategies to control costs.

A key tool in the arsenal of many PDABs is the implementation of Upper Payment Limits (UPLs), which set maximum price caps that state programs will pay for certain medications.


What’s at stake for patients?
  • Affordability, from a patient perspective, means access to essential medications and treatments without facing financial hardship, ensuring equitable healthcare access and robust patient protections.
  • Patients may face limited access to specific medications if manufacturers do not lower their prices to meet UPLs, potentially affecting their ability to obtain essential treatments.
What’s at stake for providers?
  • For providers, it involves delivering quality care without being constrained by cost considerations.
  • Providers may need to consider alternative medications for their patients based on UPLs and affordability, potentially altering treatment plans and impacting patient care.
What’s at stake for payers?
  • Payers work to strike a balance between controlling expenses and safeguarding patients’ equitable access to necessary healthcare services.
  • Payers must navigate changes in drug pricing strategies and formulary designs due to UPLs, potentially affecting which drugs are covered and how costs are shared with patients.

Take Action in Your State

Prescription Drug Affordability Boards can influence how states evaluate drug costs, set affordability policies, and determine which treatments receive additional scrutiny. This Action Center helps patients, providers, and advocates understand those decisions and participate in the process.

Access your state’s information below, and contribute via one of the following ways:

  • Learning more about PDABs via this page’s resources.
  • Joining PDAB or PDAB Advisory Group meetings.
  • Submitting written or oral testimony.
  • Commenting during rulemaking and affordability reviews.
  • Contacting board members, agency officials, and state legislators.
  • Sharing patient and provider experiences with treatment access.

Common Themes and Actions
  • Differing 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.
  • Ongoing Legislative Adjustments and Challenges: Each state is at a different stage in their legislative deliberations concerning drug affordability and any potential operational changes to PDABs.
  • Increasing 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.
Key Takeaways for Strategy and Coalition Principles
  • 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.

Related Health Policy Resources

PDABs are part of the broader national and state-level drug affordability landscape.

These resources address related health policies and decisions that can affect care, coverage, cost, and access.

Browse All Resources

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