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Md. leaders hope drug board sets the bar for the nation

Del. Bonnie Cullinson, D-Montgomery

Del. Bonnie Cullison, D-Montgomery

Maryland lawmakers, elected officials and advocates praised the novelty of a new law to create a board to review the prices of high-cost prescription drugs, even as the earliest possible action it could take on prices is 2021.

The law to create a Prescription Drug Affordability Board took effect Monday, and lawmakers hope this attempt to do something about the rising price of prescription drugs sticks.

“We believe that we have found a way to really begin to address the pricing process and then begin to address those unjustified processes here in the state of Maryland,” said Del. Bonnie Cullison, D-Montgomery, who served as the bill’s floor leader in the House of Delegates.

The legislation to create the drug board passed with votes from both parties and was allowed to become law without Gov. Larry Hogan’s signature. It was sponsored by Sen. Katherine Klausmeier, D-Baltimore County, and Del. Joseline Peña-Melnyk, D-Prince George’s and Anne Arundel.

Under the new law, the Prescription Drug Affordability Board can seek approval in July 2021 to set upper payment limits for high-cost drugs purchased for state and local government employees as a pilot program.

Any limits would have to be approved by the Legislative Policy Committee, made up of every standing committee chair and party leader in the Senate and House of Delegates.

The board could go back to the full legislature in 2023 for permission to expand payment limits beyond just government employees.

The membership of the board has not yet been appointed. It will be made up of one member each appointed by the governor, the president of the Senate, the speaker of the House of Delegates and the attorney general.

A fifth member will be jointly appointed by the president of the Senate and the speaker of the House. That member will serve as the board’s chair.

Cullison hailed the prescription drug board as an opportunity to clarify what goes into setting the price for prescription drugs.

“It puts us in a mode where we are going to try to demystify, demystify prescription drug pricing. It is extremely complicated,” she said. “People have spent hours with me and explaining to me all of the different elements of the drug pricing process and it is mind-boggling.”

The new law was the latest attempt by the General Assembly to try to rein in the cost of prescription drugs.

In 2017, the legislature passed a bill that would have allowed the state’s attorney general to sue generic drug manufacturers if they were believed to engage in price gouging. 

That measure was found to be unconstitutional by the 4th U.S. Circuit Court of Appeals in a decision that Maryland Attorney General Brian Frosh called “bizarre” Monday.

He also praised the new law as a way to address high-cost drugs.

“This bill is a great way of addressing the unconscionable increases in drug prices, prices that are unexplained by the increases in the cost of manufacturing or increase in the cost of marketing,” he said.

The bill as it was originally introduced would have had more teeth. It would have allowed the drug board to set payment limits for the entire state without having to get permission from the legislature’s leaders.

Compromises and negotiations eventually resulted in the bill that took effect Monday.

State Sen. Brian Feldman, D-Montgomery, who served as the bill’s floor leader in the Senate, also took the opportunity Monday to criticize the 4th Circuit’s decision in the price gouging case, calling it “poorly written.” 

He said other states are going to have to pass laws like Maryland’s because the federal government cannot be counted on to solve the issue.

“Unfortunately the United States Congress could be helpful here, but they don’t do anything,” he said. “The fact is the action and the leadership on that subject is going to have to come from the states, it is going to have to come from the state capitals. And we in Maryland really wanted to be, the last couple of years, a leader with innovation, first in the nation (with) ideas.”

There are already signs that other states may look to use the Maryland law as a model for their own legislative attempts.

Wandra Ashley-Williams, vice president of the state NAACP and a national board member for the organization, said she has written a resolution that would call for each state conference to support legislation modeled after the Maryland law in their own jurisdictions. The group’s national convention is in Detroit later this month.

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