In 2021 the Oregon Legislature passed Senate Bill 844, creating the Oregon Prescription Drug Affordability Board (Oregon PDAB). Today, the board is charged with annually identifying nine drugs and one insulin product that it determines may create affordability challenges for the Oregon health care systems or high out-of-pocket costs for Oregonians. It is also charged with developing a mechanism for establishing upper payment limits on those drugs it has reviewed.
Oregon Bioscience Association—along with the voices of many patient groups and health leaders—is growing increasingly concerned at the present state of the board’s deliberations and process. Our members in the region—counting 1,480 life science firms, leading academic and research institutions, generating as many as 66,000 jobs—create and conduct life-saving testing, research, development and distribution of medicines, innovative therapies and new health technologies.
What concerns our members, including today’s scientists and health thought leaders, is what the Oregon PDAB is missing in a rushed process to meet statutory deadlines.
Many questions exist about the pricing data used to select and then review the drugs, and the minimal outreach and input from patients, physicians and other health care stakeholders regarding pricing, access and the value of the drugs being reviewed.
From an outside perspective, it appears the board and its staff are overly focused on asking consumers if their drugs are too expensive, as opposed to a thorough review of the benefits, savings and overall value of various therapeutic treatments or, for that matter, why a given patient’s drugs are too expensive.
For example, an “expensive” drug that provides patients with effective treatment and avoids even more expensive medical procedures provides true value to patients and the health care system. And all too often different patients pay drastically different amounts for the same drugs because their insurance companies set the prices that patients pay.
Oregonians should expect accountability from all public bodies, including one as experimental as the PDAB. Citizens should seek further details about the board’s work plan and process, and the legislature should require it. Due to an aggressive 2024 review schedule, the board has been asked by many patient groups and leading health organizations to delay current drug reviews until processes are implemented for meaningful patient, provider and other stakeholder input that can be incorporated into the board’s deliberations.
The Oregon PDAB is structured based on a “model bill” pushed (or passed) in a handful of other states. Some states have gone so far as to grant their PDAB the authority to implement caps on reimbursement for prescription drugs commonly referred to as “upper payment limits” or “UPL authority.” No state has yet implemented a UPL, and nobody knows how or if it will work.
Before the Legislature considers authorizing the Oregon PDAB untested UPL authority, the board must first acquire the data, expertise and processes for stakeholder input required to properly select and review drugs.
Like the science of our member companies in developing life-saving drugs is complex and time-consuming, we ask that the work of the Oregon PDAB as it selects and reviews these dearly needed therapies not be hastily done.
Liisa Bozinovic of Portland is the executive director of Oregon Bioscience Association.
Most Popular
Comments / 0