State-Level Drug Pricing Policy Accelerating: Life Sciences Companies Can Contextualize Value & Access to Policymakers

While federal drug pricing reform in the Build Back Better Act (BBBA) is stalled at the Senate, states are taking the issue into their own hands.

Given this, life sciences companies need to ensure state legislators have a balanced narrative to inform consequential decisions around pricing, affordability and access to medicines. An intentional value and access external engagement strategy can communicate nuanced issues and mitigate reputational harm.

Key issues at the state level:

• Price transparency: Fourteen states have adopted prescription drug transparency laws that require drug supply chain entities – i.e., manufacturers, pharmacy benefit managers (PBMs), health plans and others – to disclose various information related to price increases and high-priced new therapies.  
• Price controls: Since 2016, 22 states enacted price controls in an effort to take more direct control of prescription drug prices.   
• Reference pricing: Mainesigned legislation requiring annual reporting on the potential savings if certain drugs were subjected to a referenced rate. 
  • Similar legislation in Rhode Island, North Carolina, Oklahoma and Hawaii incorporates Canadian reference pricing requirements. 
• Affordability boards: A recently proposed prescription drug affordability board (PDAB) in New Jersey would assess the entire pharmaceutical distribution and payment system in the state and any policy options that are being used in other states and countries to lower the list price of drugs.
• Copayment accumulator programs: As of April 2022, 15 states and Puerto Rico have enacted laws to ensure manufacturer copay assistance counts toward a consumer’s annual out-of-pocket cost-sharing requirement.

Why this matters for manufacturers: 

• Shifting state-level prescription drug price transparency requirements present a considerable compliance burden and reputational risk for manufacturers.
  • Nevada levied $17 million in fines on drug companies for noncompliance with a diabetes drug transparency law. 
• State unsupported drug price increases lists create additional market access and brand challenges.
  • Vermont publicly discloses the largest net price increases for brand and generic therapies.
  • The Institute for Clinical and Economic Review (ICER) will develop two annual unsupported price increase reports for California in 2022. 

With the steady clip of state-level reforms, life sciences companies should: 

• Understand the environment, policy landscape, trends and influencers in each state to develop targeted strategic communications campaigns. 
  • Conduct influencer identification and mapping.
  • Design value narratives tailored to state policymakers and their constituents’ top concerns, including specific benefits for Medicaid or savings elsewhere in the state budget (e.g., unemployment, state services, criminal justice).
  • Deploy communications plans and materials for one-on-one meetings with policymakers.
• Support state-level government affairs teams with a value and access external communications strategy and engagement plan to align with business objectives.
  • Customize by state and/or therapeutics in the spotlight in the state.