PDABs: An Imperfect Solution To A Complex Issue

By Elaine Tate, BSc

Prescription Drug Affordability Boards (PDABs) are emerging at the state level as a mechanism to control medicine spending and address the complex, high cost of pharmaceuticals in the U.S. While these boards hold the promise of lower-cost medicines, variations in how each state implements its PDAB have led to unpredictable and unreproducible processes. So far, no state has reached the stage of generating savings for patients, states, or health systems, creating an opportunity to refine these approaches.

To improve the PDAB framework and ensure it truly benefits patients, there are three key areas for immediate improvement. First, boards need to move beyond high-level goals and clearly define affordability by establishing systematic, consistent methods and aligning those to patient-reported affordability thresholds. Second, current methods for data collection and analysis rely too heavily on readily available cost metrics, often missing crucial real-world data like adherence and healthcare resource avoidance. Finally, PDABs must prioritize meaningful stakeholder engagement, especially with patients, caregivers, and patient advocacy organizations, whose insights on the value of eligible drugs are often dismissed or inadequately captured.

The full realization of PDABs' benefits hinges on collaboration and the development of shared best practices across states. Read on to learn more about the necessary process improvements that could make PDABs more predictable, transparent, and patient-centric.