Illinois Legislature Considers Prescription Drug Affordability Board

With 11 days left in the spring legislative session, Illinois lawmakers are discussing a proposal to form a state panel aimed at evaluating prescription drug prices and accessibility. The bill seeks to establish a Prescription Drug Affordability Board as part of a Democratic strategy to tackle affordability issues in Illinois and nationwide. Critics argue the board might not effectively reduce prices and could introduce more bureaucracy.

The bill passed 8-4 along party lines in the House Executive Committee and awaits a full House vote. Proponents view the board as a tool to control rising drug costs, an issue also being addressed federally through recent Biden-era actions. State Representative Nabeela Syed of Palatine is the primary sponsor of the bill.

Syed describes the proposal as “heavily negotiated”. It was introduced after a previous version did not advance. If established, the five-member board, appointed by the governor, would assess prescription drug prices and establish upper payment limits to cap consumer costs. Pharmaceutical companies could argue their prices before limits are set. The board would also work to enhance medication access, particularly in rural and low-income areas.

The bill ties Illinois drug prices to Medicare’s new negotiating powers under the 2022 Inflation Reduction Act. Starting this year, Medicare, covering people 65 and over and those with disabilities, negotiated lower prices for 10 expensive drugs. For instance, Januvia, a diabetes drug, saw a price drop from $527 to $113 for a 30-day supply. Syed’s bill would use these Medicare-negotiated rates as upper payment limits in Illinois for all healthcare plans. Medicaid and some state employee health plans would need to opt-in separately for technical reasons.

The board cannot lower prices further on drugs already negotiated by Medicare but can ensure those drugs reach patients needing them. Anusha Thotakura of Citizen Action/Illinois, a group supporting Syed’s legislation, highlighted an April study showing Illinois overpays by more than $190 million for the 10 drugs influenced by Medicare rates. Opponents contest this figure, but Thotakura believes it shows a significant issue.

The proposed board must include members experienced in healthcare, pharmacy, and clinical medicine but cannot include employees or consultants for drug manufacturers. Members would serve five-year terms, with staggered initial terms, and would be supported by a 15-member council appointed by the governor and legislative leaders. Board decisions could face appeals and potential judicial review. The Illinois attorney general “may” enforce the board’s regulations. Syed emphasized that any legal shortcomings can be fixed by the Illinois General Assembly.

A dozen states have active Prescription Drug Affordability Boards (PDABs), with varied effectiveness. Some, like Colorado and Maryland, have empowered their boards to set upper payment limits. The Pharmaceutical Research and Manufacturers of America opposes the Illinois bill, claiming no state-level PDABs have delivered measurable savings. They also argue the Medicare framework isn’t designed for state-level application.

Deputy Republican Leader Ryan Spain opposed the bill, citing bureaucratic issues and the absence of a state agency to oversee the board. Spain believes the board should align with an existing state entity for efficiency. Syed responded that the board would operate independently, with operational costs projected at $750,000, and did not require inclusion in a department.

A spokesperson for Governor JB Pritzker did not disclose the governor’s stance on the proposal, saying only that the proposal is under review. Meanwhile, the legislature advanced another affordability measure endorsed by Pritzker. The Senate voted 46-12 to approve a bill banning “junk fees,” prohibiting businesses from advertising prices that omit mandatory fees or surcharges. This bill awaits Pritzker’s signature.