Maryland’s Prescription Drug Affordability Board (PDAB) just took a major step toward reining in the rising cost of prescription drugs. With two widely used drugs now flagged as affordability challenges, the state is laying the groundwork for cost-cutting measures that could affect budgets and benefit plans alike.
In an effort to tackle the high cost of prescription drugs, Maryland’s Prescription Drug Affordability Board (PDAB) has unanimously determined that two common Type 2 diabetes medications, Jardiance and Farxiga, may pose an affordability challenge to the state’s health care system. As reported by Maryland Matters, the decision marks the first time any drugs have completed PDAB’s full cost review process, clearing the way for possible next steps to help rein in spending.
The board’s decision opens the door for cost-reduction strategies like upper payment limits (UPLs), a policy lever that could cap how much Maryland pays for high-cost drugs under state-funded health plans. While the board emphasized that savings won’t be immediate, the ruling sets a precedent for similar reviews of other costly medications in the pipeline.
From the article:
The board also cited out-of-pocket costs for consumers and state and local spending on those drugs as indicators that there may be an affordability challenge. The board will now look at options to address the potential affordability challenge, which could include setting an upper payment limit on those drugs.
PDAB was created by the General Assembly in 2019 and formally funded in 2023. It was designed to address the opaque and escalating prices of prescription drugs. The review process includes industry data collection, stakeholder testimony, and a deep dive into pricing trends, highlighting out-of-pocket costs, inflationary increases, and state and local spending.
In the 2025 legislative session, the Maryland General Assembly passed legislation to increase drug pricing transparency and accountability. SB 357/ HB 424 enhances the authority of the State’s Prescription Drug Affordability Board (PDAB) by allowing it to establish a process for setting upper payment limits for certain high-cost prescription drugs. MACo supported the legislation as counties, as public employers, bear the increasing costs of prescription drugs through the health insurance coverage they provide to employees and their dependents.
The board reviewed six drugs in its first round of cost analysis, with Jardiance and Farxiga reaching the end of the rigorous process. The remaining four: Dupixent, Ozempic, Skyrizi, and Trulicity, are still under review.
PDAB’s ongoing work could signal future changes in drug pricing strategies and spending across local government health care systems.
Read MACo’s testimony on PDAB authority for upper payment limits.
