Drug affordability boards, or prescription drug affordability boards (PDAB), are empowered by state legislatures to review the affordability of selected drugs, suggest drug pricing and affordability solutions, and set upper payment limits (UPL). The UPL serves as a cap on the acquisition cost and purchase price as well as reimbursement for a particular drug.
For a more in-depth overview of what drug affordability boards and upper payment limits are, click here.
The pharmaceutical supply chain and contractual arrangements providing for the delivery of care are complex. The implementation of a UPL for a provider administered drug has the potential to disrupt access to provider administered drugs by:
CSRO is working to ensure that PDABs and proposed PDAB legislation do not disrupt rheumatologists’ ability to care for their patients and receive adequate reimbursement for their services. CSRO is a member of several coalitions that work to ensure that pricing reform policies continue to allow for access to innovative treatments while reducing patient out-of-pocket costs, including the Value of Care Coalition, Aimed Alliance, Ensuring Access through Collaborative Health Coalition, and Let My Doctors Decide.
Visit our Legislative Map Tool to read about current step therapy laws or legislation in your state. You can send letters in support of pending legislation and find educational materials.
