Virginia legislators take a third shot at prescription drug affordability measure

RICHMOND, Va. (CN) — Delegate Karrie Delaney joined advocates on Thursday to announce the reintroduction of legislationcreating a prescription drug affordability board, hoping the third time’s the charm.

The independent, nonpartisan board would comprise medical and health experts who will use data to set upper payment limits on how much consumers will pay for certain medications on state-sponsored and state-regulated health plans and programs.

Delaney, a Democrat, first introduced the measure in 2023 and has enjoyed growing support each session. The bill went through the Democratic-controlled General Assembly in 2024 but met the wrong end of Republican Governor Glenn Youngkin’s veto pen.

“Though noble in its intent, the proposal carries numerous unintended consequences,” Youngkin wrote concerning the veto. “The implications of the proposed upper payment limits are detrimental for patients with life-threatening diseases such as cancer. As we are acutely aware, life-saving treatments often entail the use of high-cost drugs targeted by these affordability measures; bringing down the costs of these drugs will require full transparency of prices and discounts and more competition and economic freedom, not price controls."

Hampton resident Shalonde Dozier-Calhoun spoke about her son Seth, who fought renal medullary carcinoma, a rare kidney cancer, throughout his senior year of high school.

“At 17 years old, Seth was forced to confront his own mortality in a way no young person should,” Dozier-Calhoun said. “One of the proudest moments in our lives was watching him graduate from high school, a milestone he achieved just two weeks before he went on to heaven."

Dozier-Calhoun said that with Medicaid, Seth could afford medicines that cost as much as $20,000 before insurance. The mother said she hopes other families can afford to fight like theirs.

“He was an artist and a musician, a young man with immense talent and creativity,” Dozier-Calhoun said. “Sadly, there are people and families across Virginia who can’t afford to fight like Seth.”

Delaney blamed fearmongering tactics from pharmaceutical lobbyists for last session’s veto.

“I don’t know how we would change it to relieve concerns that I think are not accurate,” the Northern Virginia-based lawmaker said. “ I think that there have been, as I mentioned, kind of tactics, fearmongering tactics, levied against this bill that we have answers for.”

In previous sessions, the Pharmaceutical Research and Manufacturers of America trade group criticized the bill. Pharmaceutical lobbyists argue pharmacy benefit managers, the third-party administrators of prescription drug programs, are to blame for high prices.

“These boards have yet to prove to be anything more than a political scheme that fails to lower costs at the pharmacy counter,” Pharmaceutical Research and Manufacturers of America spokeswoman Stami Williams said in a 2024 statement. “Passage of this legislation would allow for unelected bureaucrats to stand between patients and doctors, pick individual winners and losers, and potentially put Virginians’ health care on the chopping block while expecting them to foot the bill.”

A 2016 study analyzing the profits of each prescription drug supply chain step estimates that manufacturers netted two-thirds of the revenue for a total of $328 billion while the intermediaries, the pharmacy benefit managers, account for only $23 billion in annual profit.

Critics also argue that affordability measures could stifle innovation. Delaney claims that pharmaceutical companies would still have the resources to develop new medications if they pulled from their advertising and executive personnel budgets.

“I think all one needs to do is look at the budget for these companies,” Delaney said. “If a big pharma company needed to cut its budget, I think they could find other sources to do that.”

In the last session, the House of Delegates passed the bill 50-47, with only one Republican joining the “yes” side. The state Senate passed it 25-15, with five Republicans voting yes and one Democrat voting down the measure.

Delaney played down recent $2,000 donations from Pharmaceutical Research and Manufacturers of America to Democratic leaders Senate Majority Leader Scott Surovell and House Appropriations Chair Luke Torian.

“I think, as a legislator, you know, obviously we pay attention when we see donations coming from, you know, certain entities and then outcomes to our bills,” Delaney said. “You know, I think accepting a contribution from an organization, to me, signals ‘I like the way this person governs and things and processes information.’”

Should the legislation pass, Virginia would join Minnesota, New Hampshire, Oregon, Washington and Massachusetts. According to a 2024 poll from KFF, nearly four in ten of those taking four or more prescription drugs say they have difficulty affording their prescriptions, compared with one in five adults who currently take three or fewer prescription medications.

According to a 2020 study by Altarum, Virginians spend less on health per capita than the rest of the country, including an average of $800 less on professional, physician, and clinical services. Still, Virginians spend an extra $400 on prescription drugs, equating to 36% more than the national average.