The EACH/PIC Coalition submitted a comment letter to the Maryland PDAB providing input on the draft annual report to the Maryland legislature.
The letter stated:
“We urge the board to more clearly center its cost reviews on patient-reported affordability rather than system-level cost pressures. In the board’s most recent cost reviews, Ozempic and Trulicity were not found to present affordability challenges for patients themselves. Despite this, the board’s actions could ultimately place these therapies at risk of reduced availability.”
“As we have emphasized in earlier comments, cost reviews and UPLs introduce new incentive structures that lead payers to restrict access, impose new utilization management, or alter formularies in ways that disadvantage patients. These risks are not hypothetical. CMS has similarly warned that pricing interventions can incentivize plans to steer patients away from selected drugs through unfavorable tier placement or additional utilization controls.”
“Maryland should avoid setting a precedent in which state cost pressures outweigh the lived experience and clinical needs of patients. As our prior comments noted, when policy decisions drive patients toward switching stable therapies for non-medical reasons, the consequences can include treatment failures, worsening symptoms, and higher overall medical costs. Therefore, we urge the board to center cost reviews on the experiences and needs of patients.”