PDAB Implementation Challenges Slow State Drug Cost Efforts

Nine states have established Prescription Drug Affordability Boards to control drug costs, but implementation has proven complex and lengthy. Virginia's Governor Spanberger vetoed PDAB legislation citing ineffectiveness and high costs. Maryland, Colorado, Washington, and Minnesota have authority to set upper payment limits, though none have taken effect. Colorado finalized its first UPL in October 2025, effective January 2027. New Hampshire repealed its PDAB, while Louisiana passed limited transparency-focused legislation.