Bill > SB271

This bill establishes the Prescription Drug Affordability Board (the Board) to protect citizens from high prescription drug costs by conducting affordability reviews of certain drugs sold in the Commonwealth, considering factors that indicate affordability challenges or high out-of-pocket costs for patients. The Board will be supported by a stakeholder council, will meet regularly, and its members must disclose conflicts of interest. The bill also amends existing law to include "non-claims payments" in the data collected by the All-Payer Claims Database, which is used to improve healthcare access, quality, and cost, and adds a requirement for the database to report annually on prescription drugs with significant price increases or rebate decreases to a new Prescription Drug Affordability Advisory Panel. This Panel, composed of six members with expertise in relevant fields and appointed by the Governor, will analyze drug pricing trends, develop policy recommendations, and report findings to the Governor and legislative committees, with quarterly updates also provided. Furthermore, the bill introduces provisions for setting "maximum fair prices" for certain prescription drugs, with specific definitions for terms like "generic drug," "health plan," and "referenced drug," and outlines penalties for violations, including manufacturers withdrawing drugs to avoid price limitations. The bill also mandates that savings from these price limits be passed on to consumers, prioritizing reductions in out-of-pocket costs, and requires health plans, state entities, and participating ERISA plans (Employee Retirement Income Security Act plans, which are employer-sponsored health plans) to report on these savings. Provisions related to the maximum fair prices will take effect on January 1, 2027, and certain other provisions of the bill will expire unless re-enacted by the 2028 General Assembly session.

Budget and Finance, Health and Social Services

https://lis.virginia.gov/bill-details/20261/SB271