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Maryland Green Lights Plan to Cap Costs for Certain Prescription Drugs

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A plan to limit how much the local and state governments pays for certain high-cost prescription drugs is moving forward in Maryland.

Lawmakers have granted the state’s Prescription Drug Affordability Board (PDAB) permission to implement a plan that could cap how much local- and state-sponsored health plans pay for certain prescription drugs. AARP Maryland, which has long fought for prescription drug affordability, applauded the decision.

“Drugs do not work if people can’t afford them,” said AARP Maryland State Director Hank Greenberg. “We are grateful to the Legislative Policy Committee for their decision, which will benefit countless Marylanders affected by rising prescription drug prices.”

Maryland’s Legislative Policy Committee, comprised of state senators and delegates, voted 16 to 5 on Oct. 22 to allow the state’s PDAB to proceed with its Upper Payment Limit Action Plan. The plan allows the PDAB to review six specific drugs to determine if they are unaffordable for consumers who get them through a local- or state-sponsored health care plan. The review will also investigate whether setting a payment limit on what health care plans pay for the drug will actually lead to lower costs for consumers. If the limits won’t result in savings or could decrease access to the drugs, the PDAB can forgo them.

It’s an “extremely robust process that’s transparent with significant opportunities for public comment and community engagement from patients, clinical experts and other experts,” Andrew York, executive director for the PDAB, told lawmakers in an Oct. 22 hearing on the plan.

The six drugs selected by the PDAB for review are Dupixent, Farxiga, Jardiance, Ozempic, Skyrizi and Trulicity, which address conditions including Type 2 diabetes, heart disease, kidney disease, eczema, Crohn’s disease and others.

While AARP Maryland has praised lawmakers’ approval of the plan, we are also urging expansion of the PDAB’s authority so the Upper Payment Limit Action Plan can apply to all Marylanders, not just those on a local- or state-sponsored health care plan, like Medicaid or a government employee plan.

“Rising prescription drug costs continue to burden Maryland’s senior population, and this plan offers a critical framework for addressing the issue,” Greenberg said. “Moving forward, AARP would like to see these savings apply across the board to all Marylanders.”

Bringing down the cost of prescription drugs in the U.S. is a priority for AARP. In 2022, we were instrumental in helping to pass a historic prescription drug law that is lowering prices and out-of-pocket costs for millions of Medicare beneficiaries. This year, we’ve continued to support and weigh in on many federal and state actions aimed at making medications more affordable for older adults around the country.

Read more about our efforts to lower prescription drug costs and keep up with AARP’s health coverage.

Also of Interest: 

Medicare Unveils First Negotiated Prices for 10 of the Costliest Medications
More Than 3 Million Older Americans Will See Rx Savings With Out-of-Pocket Cap
9 in 10 Older Adults Rely on Prescription Medications

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