Considerations and Implications of PDABs and Their Impact on 340Bs

Prescription Drug Affordability Boards (PDABs) are designed to help reduce the costs of prescription medications in 11 states where they currently exist (legislation pending in 13 more states). Although the scope of PDABs varies, they typically conduct affordability reviews of medications deemed ‘unaffordable’—to patients, the state’s healthcare budget, or both. Certain states further set Upper Payment Limits (UPLs) for specific drugs. But, UPL measures might unnecessarily limit formulary (medication or plan benefit design) options, affecting patient choice and reimbursement rates for some interconnected drug discount programs like 340B.