Legislators Will Seek to Cap Prescription Drug Prices in Virginia

Armed with an AARP poll showing strong public support for the idea, a bipartisan duo of state legislators will urge the Virginia General Assembly next year to create an agency to review prescription drug prices and limit how much pharmaceutical companies can charge for certain medications.

Republican Sen. Bill Stanley of Franklin County and Democratic Del. Karrie Delaney of Fairfax said they will sponsor legislation to create a Prescription Drug Affordability Board (PDAB) as seven other states from Maryland to Oregon have done.

“This is a matter of life or death,” Stanley said. In both rural and urban areas of Virginia, he said, people with limited income must decide whether to buy “that prescription drug or put food on the table or a roof over their heads.”

“The cost of managing to stay alive is just astronomical,” Delaney added. She said prescription drug prices often are inflated because of the “ridiculous amount of money being spent on marketing and advertising.”

During the 2023 legislative session, Republicans in the House of Delegates blocked bills to establish a board to rein in drug prices. But when lawmakers convene in January, they might look more favorably on the proposal, Stanley said.

That is because all 100 seats in the House and 40 in the Virginia Senate are up for election this fall. Due to redistricting and retirements, at least one-third of the seats will be filled by newcomers, Stanley predicted.

“What you’re going to have is a bunch of new free-thinking people that are not beholden to the lobby effort of Big Pharma,” he said. “I have great hope that the new General Assembly in 2024 is going to be constituent-oriented in its thinking and not lobbyist-oriented.”

Delaney and Stanley spoke at a virtual news conference at which AARP Virginia officials released the results of a poll showing that three out of four Virginia voters support creation of a PDAB. The board would have the power to set limits on how much Virginia residents and institutions – from state agencies to health plans to individuals – would pay for prescription medications.

“In an age in which voters don't always agree on much, they agree on this: The skyrocketing costs of prescription drugs is a critically important issue, and a Prescription Drug Affordability Board is a good solution,” said AARP Virginia State Director Jim Dau.

“Every candidate running for the General Assembly this fall should know that supporting a drug affordability board is a common-sense, bipartisan way to win over voters.”

Regardless of political party, Virginia voters support creation of a PDAB, according to the public opinion survey conducted by the Wason Center for Civic Leadership at Christopher Newport University. The poll, commissioned by AARP, found that 85% of Democrats, 71% of Republicans and 70% of independents backed the idea.

Respondents also expressed support for other ways to lower prescription drug prices:

● 86% of the voters said Virginia should join other states to buy prescription drugs in bulk at a discount.

● 77% support allowing Virginia to import prescription drugs from Canada and other countries that have safety and quality standards equivalent to those in the United States.

● 76% support establishing a maximum amount Virginians would pay for certain drugs based on the price for the same medication in Canada.

Dau said Americans pay the highest drug prices of any developed country. For example, prescription drugs in the U.S. often cost more than double what they do in Canada. And overall, Virginians pay 36% more than the U.S. average for prescription medications, Dau said.

The survey found that Virginians have much at stake in the debate over prescription drug prices. Two-thirds of the respondents reported that they take prescription drugs regularly, often costing hundreds or even thousands of dollars a month. More than a third of the people polled said they have skipped getting prescriptions filled because of the cost.

Prescription drug prices have risen much faster than inflation, Dau said. If other products had increased as much as drug prices have climbed, a gallon of milk would cost $13 and a gallon of gasoline more than $12.

The poll, conducted June 6-20, involved a telephone survey of 1,000 registered voters, age 18 and older, in Virginia. It had a margin of error of 3.7 percentage points.

The survey results “validate what I hear from my constituents when I’m out at their doors – that necessary, life-saving medication is too often out of reach, and they support any and all efforts to reduce health-care expenses, including a Prescription Drug Affordability Board,” Delaney said. “The General Assembly must come together in 2024 to pass this legislation and save millions of dollars for hardworking Virginians.”

Delaney sponsored a bill to create a PDAB during the legislative session held in January and February. However, it died in committee in the Republican-controlled House of Delegates.

Sen. Chap Petersen, D-Fairfax, sponsored a companion bill in the Senate. Five Republican senators, including Stanley, joined the 21 Democratic senators in passing the measure. The legislation then was sent to the House, which killed it.

The PDAB bills had drawn opposition from the pharmaceutical and biotechnology industries as well as from Republican Gov. Glenn Youngkin's administration.

Scott Johnson, a lobbyist for the Virginia Biotechnology Association, said in January that a PDAB would have a chilling effect on drug research.

James Williams, a deputy secretary of health and human resources, told legislators: “We don't think a part-time board should regulate this industry. It's a very sophisticated and complicated industry, and health insurers will tell you they spend a lot of time looking at the value of these medicines.”

Stanley and Delaney rejected the notion that a PDAB would stifle research and innovation by drug companies.

“I find that to be malarkey,” said Stanley, who has served in the Senate since 2011. “And I think it is the old corporate saying that has kept governments out of trying to regulate the prescription drug business in a financial way that is good for the consumer.”

Just as the state regulates public utilities to ensure they aren't making excessive profits, Virginia has a legitimate interest in regulating prescription drug prices, Stanley said. “These drug companies have been getting almost an unreasonable amount of return.”

Delaney said the PDAB would give drug companies the opportunity to prove that the prices they charge “are needed for research and development and not for marketing.”

“What this board does is, it gives the opportunity for these drug makers to demonstrate why these drugs cost so much. … If there's justification, the board will see it,” she said.

Delaney, who was elected to the House in 2017, has a personal connection to the issue of prescription prices.

“I have a daughter with Type 1 diabetes. So I'm well aware of the tremendous expense and just hardship with managing a lifelong illness,” Delaney said.

The PDAB debate is not the first time that the General Assembly has tackled the cost of drugs. In 2020, legislators passed a bill prohibiting health insurers from charging more than $50 for a 30-day supply of insulin. Then-Gov. Ralph Northam, a Democrat, signed the legislation into law.

In a controversy like the one over the PDAB, insurance company officials opposed the insulin bill. But as Stanley said, the multibillion-dollar health-care industry “did not suffer from the cap on insulin prices.”

The perspective of a doctor and a patient

At the news conference, Dr. Rommaan Ahmad, a sports medicine and pain management specialist in Alexandria, said that every day, she sees patients struggling with prescription drug costs that can run into the tens of thousands of dollars a month.

“Prescription drugs don’t work if people can’t pay for them. I’ve had patients call me in a panic many times because things are getting too expensive,” Ahmad said.

“When a particular medication doubles or triples in price, it’s not two or three times more effective,” she said. “A Prescription Drug Affordability Board can hold these big companies a little accountable … for what they’re charging Virginia families.”

One Virginian who would like to see more accountability is Jillian Goodwin, 31, of Norfolk. She has cystic fibrosis, a genetic disorder that damages the lungs, digestive system and other organs.

“Every day, I take about 20 different prescription medications to stay alive and maintain my health,” Goodwin said.

She said she is fortunate to have employer-sponsored health insurance and to be eligible for several co-pay assistance programs. That coverage has reduced her monthly out-of-pocket medical expenses from $1,600 – more than her mortgage – to “just a couple hundred dollars.”

“Without insurance … I truly wouldn't be here today,” Goodwin said. She noted that one of her drugs – Trikafta, which has greatly reduced hospitalizations and increased life expectancy for people with cystic fibrosis – retails for $360,000 a year.

“What good is a medical marvel and a revolutionary breakthrough if the people who need it cannot afford it?” Goodwin said.

“That is why I am one of the overwhelming majority of voters who support creating a Prescription Drug Affordability Board. I think it is time for lawmakers to hold drug companies accountable for these skyrocketing costs that outpace inflation and make it harder and harder for people to maintain their health.”