Panel advances bill to create Prescription Drug Affordability Review Board after hours of testimony

RICHMOND, Va.

The House Labor and Commerce Committee on Tuesday voted 12-9 to report House Bill 1724 and referred the measure to the Appropriations Committee. HB 1724 would establish a Prescription Drug Affordability Review Board that could review steep price increases and set upper payment limits for specified drugs.

The bill's patron, Delegate Danica Delaney, described the proposal as a response to rising out-of-pocket costs. "The cost of simply staying alive in Virginia is much too high," Delaney told members, saying the board would consist of medical and health-care professionals who could review price hikes and set upper price limits when appropriate. The bill would trigger reviews when a drug's price increases by more than 10 percent or $10,000 in a 12-month period; manufacturers would report and could present justification to the board before any limit was set.

Supporters included patient advocates and policy groups who said the board could restrain extreme price spikes that make lifesaving treatments unaffordable. Rena Hicks of Freedom Virginia, advocates from Rare Access Action Project and CF United, the Virginia Catholic Conference, the Virginia Association of Counties, and the Commonwealth Institute for Fiscal Analysis registered public support or testified in favor.

Opponents — including physician groups, biotechnology and industry representatives, state medical specialists, and consultants — warned of unintended consequences. Testimony from Rainier Simmons argued the proposal did not adequately consider impacts on Medicaid rebates and the 340B program, citing analysis from other states suggesting upper payment limits (UPLs) could reduce rebate values and thereby lower federal matching dollars. A caller representing rheumatology and oncology societies said that patient cost-share is determined primarily by insurers and pharmacy benefit managers (PBMs), not list prices, and urged attention to PBM reform rather than UPLs. Industry groups including the Biotechnology Innovation Organization and trade representatives also opposed the bill.

Several patient speakers described painful experiences. Amanda Boone, founder of CF United, said her group's experience under Colorado's review process was traumatic and that independent patients fear restricted access and increased insurer denials. Other rare-disease patients urged safeguards for specialty populations.

Supporters stressed built-in limits: testimony noted the board could set no more than 12 upper payment limits per year, and that manufacturers would have opportunities to explain price changes and to participate in a public process. After questions from members and nearly twenty minutes of public testimony, the committee approved a motion to report HB 1724 and send it to appropriations by a recorded vote of 12 to 9.

The committee record shows extensive written and oral testimony both for and against the proposal, and committee members indicated the bill will face further scrutiny in Appropriations, where cost and budgetary interactions with Medicaid and other state programs will be evaluated.