Inside Health Policy
May 7, 2025
Excerpt:
“Maryland Governor Wes Moore (D) is expected to sign a bill that expands the state’s prescription drug affordability board’s upper payment limits to cover drugs purchased by any provider in the state, after the bill passed with a healthy majority in both legislature chambers earlier this year.
Vinny DeMarco, president of Maryland Health Care for All, told Inside Health Policy Moore said he would sign the bill, and DeMarco said Moore’s state agencies endorsed the bill. Another source close to the legislation told IHP they were informed the governor plans to sign the bill.
Andrew York, executive director of the Maryland Prescription Drug Affordability Board, also told IHP there has been no indication that the governor would not sign the bill.
The governor has two more bill signing events scheduled this month, one on May 13 and another on May 20.
“As Governor Moore reviews the hundreds of bills put forward this session, he will continue to work with the State Legislature, local leaders, and all partners involved to ensure that we are signing legislation that will make Maryland safer, more affordable, more competitive, and the state that serves,” Moore’s senior press secretary Carter Elliott said in a statement.
The bill will amend current law under which the upper payment limits (UPLs) reached by the board only apply to drugs purchased by public insurance plans. That approach contrasted with other state boards; in Colorado, for example, the UPL applies to all purchases of and payer reimbursements for the drug.
The bill changes the law to now mimic Colorado, allowing UPLs to apply to all payers. The bill does not apply to purchases and payment reimbursements under federal programs.
The bill also prohibits a UPL from being set on a drug in shortage and requires the prescription drug affordability board (PDAB) to consult with the Maryland Medical Assistance Program prior to setting a UPL, as well as considering the effects on providers of 340B drugs when setting a UPL.
DeMarco said there were efforts to include an exemption for orphan drugs from UPLs in the bill, which ultimately failed. A similar effort was seen in Colorado that also failed, with the governor instead signing a bill that would require the PDAB to consider input from the Colorado rare disease advisory council in determining which drugs are unaffordable for patients in the state and in setting potential payment limits.
“Big PhRMA tried to weaken the bill by exempting so called ‘orphan drugs’ but the legislature rejected it because the PDAB should be able to look at all high-cost drugs to see how it can make them more affordable for Marylanders,” DeMarco said.”
Read the full article at Inside Health Policy.
Last modified: June 4, 2025
