Prescription Drug Affordability Boards (PDABs) Resource and Action Center
With PDABs becoming increasingly popular 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
Latest Resources
Browse Resource Library-
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.
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PDAB Action Steps for Patients
Patients looking to contribute to the conversation about drug affordability and Upper Payment Limits (UPLs) can start here.
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PDAB: Balancing the Scale
The Role of PDABs in Drug Pricing and Healthcare Stakeholder Impacts
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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).
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Prescription Drug Affordability Boards (PDABs) and Upper Payment Limits (UPLs) Impact on Patients, Drug Pricing, and Innovation
This HealthHIV Advocacy paper explores the function of Prescription Drug Affordability Boards (PDABs) in managing prescription drug costs, considering perspectives of patients, providers, and payers to ensure equitable access to vital medications while controlling healthcare expenses.
PDAB Action Center
This information offers a straightforward way to help inform your thoughts and concerns, share your experiences, and actively participate in shaping policies that directly impact patient care and access.
- With momentum provided by the Inflation Reduction Act, a number of states have implemented—or are considering implementing—Prescription Drug Affordability Boards (PDABs) in order to tackle drug costs. Learn more here: https://healthhiv.org/pdab/
- Prescription Drug Affordability Boards (PDABs) introduce a new and complex dynamic in the ongoing efforts of public and private entities to negotiate drug prices and reimbursement rates. Read #HealthHIV’s latest advocacy paper on PDABs here: https://healthhiv.org/resource/prescription-drug-affordability-boards/
- Prescription Drug Affordability Boards (PDABs) must balance system-wide financial concerns with the actual impact on patients’ out-of-pocket costs. Explore #HealthHIV’s PDAB Resource Center to learn more about this: https://healthhiv.org/pdab/
- Overall, PDABs’ approach must balance broader—system-wide—financial concerns with the actual impact on patients’ out-of-pocket costs, but does not always do so.
- The evidence regarding the effectiveness of PDABs in reducing list prices or reimbursement rates is also still emerging, and it remains to be seen whether and how these reductions will actually translate into real-world direct savings to patients.
- Existing evidence does suggest, however, that the impact of PDABs on reducing patient out-of-pocket costs and enhancing access to medication remains complex, and varies from state-to-state.
- While PDABs are meant to analyze statewide drug pricing and recommend strategies to lower patient spending, their effectiveness largely depends on factors like the existence of cost-offsetting patient assistance programs, and better access to both real-world and claims data.
- PDABs must work with patients and stakeholders across various disease states and conditions—whether rare, orphan, or communicable—to serve the dual goals of both preserving and improving medication access, and containing costs.
- Only with these dual goals—and this broader context—as PDABs’ north star will the needs of patients truly be put first.
PDABs by State
Learning from Other States: States like Minnesota may look to the experiences of others, such as Colorado, 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.
