Manatt Health Releases 50-State Survey on Status of States’ Drug Affordability Board Initiatives

Report, which includes Washington, D.C., spotlights states implementing drug affordability review boards and details legislative landscape and legal challenges

Manatt announced today the release of a comprehensive survey that analyzes the status of all states’ prescription drug affordability review boards legislative initiatives. The report, titled, “State Drug Affordability Boards: A Comprehensive Review of Enacted and Pending Legislation,” found that 17 states have either authorized the implementation of prescription drug affordability review boards or commissions, or have explored their establishment through legislation.  

The report is the first to analyze the current legislative landscape pertaining to such boards nationwide, as well as detail the potential legal and market implications to come. States are increasingly adopting “affordability boards” as a means to reduce drug spending, and while these boards may become powerful new players in drug pricing, there is also a risk of them having little influence given the many questions related to their legal authority to set reimbursement levels.

“Debates over how to address rising prescription drug prices have taken center stage in recent years and have intensified in light of the historic 2020 pandemic, even as federal legislative efforts to reform prescription drug pricing have stalled during our public health emergency,” said Sandy W. Robinson, managing director with Manatt and lead author of the report. “With drug affordability boards gaining popularity among states as they work to lower costs, our report highlights the most pressing, unanswered questions, and breaks down the current legal and regulatory implications for multiple healthcare stakeholders.”

Among the 17 states that are moving forward with such boards, Manatt Health found that six have already enacted legislation to create an affordability board or commission, and four states have more than one piece of affordability board legislation that has been enacted or is pending. Among states with enacted or pending legislation, the survey includes the following key details:

  • Status of the state affordability board legislation
  • Whether the legislation authorizes the affordability board to set reimbursement levels
  • Differential treatment for off-patent single-source, generic, patented (branded) and biosimilar drugs
  • Payers that are under the affordability board’s purview
  • Information the affordability board can request from a manufacturer and whether it may be publicly disclosed
  • Enforcement and operationalization of the affordability board’s recommendations
  • Composition of the affordability board

An infographic to help illustrate the findings can be found here. The full report, including a breakdown of legislative status and legal concerns can be located through a subscription to Insights@Manatt Health, an original content information service providing a wide range of premium analysis and data on breaking industry news and trends; in-depth evaluation of state and federal health policy changes; detailed summaries of Medicaid, Medicare and Marketplace regulatory and sub-regulatory guidance; and 50-state surveys on critical industry issues.

This report was compiled through an in-depth review of enacted and proposed legislation in all 50 states and Washington, D.C. related to the establishment of drug affordability boards. It is the latest Manatt Health analysis to break down some of the most pressing policy issues facing industry stakeholders in today’s constantly evolving regulatory environment. It closely follows the release of the recent Manatt Health report detailing states’ social determinants of health (SDOH) initiatives through Medicaid managed care contracts and 1115 waivers, which can be found here.



pursuant to New York DR 2-101(f)

© 2022 Manatt, Phelps & Phillips, LLP.

All rights reserved