The EACH/PIC Coalition submitted a letter to the Illinois House Health Care Availability and Accessibility Committee opposing passage of HB 1443, which would create a Prescription Drug Affordability Board (PDAB) with the authority to implement upper payment limits (UPLs) in the state. The letter urged lawmakers to focus instead on patient-centered reforms, including PBM reforms.
The letter stated:
“The Ensuring Access through Collaborative Health (EACH) and Patient Inclusion Council (PIC) urges your committee to oppose or amend legislation sponsored by Rep. Nabeela Syed to establish a Prescription Drug Affordability Board (PDAB) in Illinois with the authority to set upper payment limits (UPLs) for selected drug therapies.”
“EACH has been actively working with PDABs in multiple states and has seen firsthand the limitations of the PDAB model. Based on our experience, we believe PDABs are ineffective in identifying and solving the actual barriers patients face when attempting to access high-cost medications. … Contrary to the claims of PDAB supporters, UPLs do not directly lower patient OOP costs and have little impact on overall patient costs. In reality, setting UPLs for drugs can endanger patient accessibility and limit appropriate reimbursement for the physicians and pharmacists.”
“EACH/PIC shares in your goal of lowering drug costs for patients and applauds the Illinois legislature for being out-front on reforms that actually benefit patients, such as banning copay accumulator/diversion programs and reforming many anti-competitive pharmacy benefit manager (PBM) practices.”
“We urge committee members to continue their focus on these non-UPL reforms, especially ‘delinking’ PBM compensation from the price of the drug. This reform (already enacted in Colorado and by Congress for Medicare Part D) is estimated by the USC Schaeffer Institute to save up to 15 percent in annual net drug spending if implemented nationwide, simply by removing the perverse incentive for PBMs to cover the highest-cost drugs for which they can extract the highest drug rebates.”