Prescription Drug Affordability Board Activity, May 2025

John Murray declared a conflict of interest and disclosed that he had spoken to the board chair and executive director to propose expanding the PDAB’s discussion to ways prescription delivery systems have saved money in other states. He noted that public sentiment presumed that conversations about affordability would lead to UPLs, and Murray wanted to push the PDAB to be different from others. 

Executive director’s program update

Senate Bill 289 passed in both committees and will head to the governor's office. The changes include: 

• Revising the number of affordability reviews from “9 drugs a year” to “up to 9 drugs a year”
• Removing the requirement that the Department of Consumer and Business Services provide the board with prescription drugs each calendar quarter
• Replacing the annual generic drug report requirement with a new provision that relevant content would be incorporated into the affordability review reports
• This bill would not go into effect until January 2026. 

Legislation Update

HB 2057: Deals with 340B program. Awaiting scheduling for floor vote. 

HB 2149: Create a new licensure and regulatory program for PSAOs. In the House Rules Committee. 

HB 2385: Relates to 340B program and prohibits drug manufacturers from interfering with 340B acquisition process. Awaiting Senate floor vote. 

HB 3212: Significantly expands regulation of PBMs. In the House Rules Committee.  

SB 533: Deals with 340B program. Awaiting scheduling for floor vote.

• Tiffany Westrich-Robertson [AiArtritis, Ensuring Access through Collaborative Health (EACH) & the Patient Inclusion Council (PIC)] -  She expressed appreciation for the earlier conversation about the Oregon PDAB being innovative in its approach to lowering the costs of medicines. They also expressed appreciation for adding patient advocacy groups to the patient collection data, but are concerned about the robustness of this data. She encouraged the Board to keep patient experience at the center of their discussion, and said a narrow focus on payer cost could miss the true impact on access to medicines. 
• Bill Schmidtknecht (Patient Protector) shared the story of the loss of his son, who was priced out of his medicine. Schmidtknecht advocates for PBM reform. 
• Derek Flowers (Value of Care Coalition) was concerned that the number of therapies to be reviewed and the proposed timeline would not permit all impacted parties to be taken into consideration. He said that there was potential for each drug to only be given 20 minutes of deliberation. He also commented that UPLs could be authorized in the future, and these discussions would lay the groundwork for potential public policy. 
• Dharia McGrew (Pharma) brought up the board's pause in deliberation last year, saying that the reasons for the pause, including the desire to better define affordability, have not been solidified yet. She also expressed concern about the timeline for the amount of drugs being considered for affordability review. 
• Brian Mayo (Oregon State Pharmacy Association) urged the board to take more actionable steps by learning from other states that have successfully implemented cost-saving strategies. Mayo specifically called on the elimination of spread pricing by PBMs to improve patient access. 

Board discussion on timeline, process, and voting methodology for affordability review determinations

The board is troubled by the number of drugs currently on the list for consideration and decided that voting on which drugs will be considered for review will take place in November, rather than voting on which drugs will advance after each month’s presentations. 

Board review and vote on final generic drug report 

Staff walked through the generic drug report, highlighting the changes made, for board comment. Assuming minor changes would be made, the board passed the motion to send the report to the Oregon legislature. 

• Lindsey Silva (a mother and primary caregiver to someone living with cystic fibrosis, commenting on Creon) spoke about her daughter's experience with switching insurance and needing to prove failure on another drug before being allowed to switch back to Creon. She opposed reviewing Creon because she wanted to ensure her daughter’s access. 
• Zach Lynkiewicz (HIV and Hepatitis Policy Institute) did not believe that HIV medications, including Odefsey, should be a part of the affordability review process. He cited substantial programs in Oregon that ensure access and expressed concern that the affordability review and the prospect for UPLs could affect insurers' decisions.
• Lucy Thornehaven (National Psoriasis Foundation, commenting on Humira) talked about her experience as a patient with Crohn's Disease. She is concerned about creating scenarios that would prompt insurers to change formularies or restrict access to critical drugs. 
• Mary Jo Strobel (American Partnership for Eosinophilic Disorders) urged the board to consider limited FDA treatment for eosinophilic esophagitis and to ensure that Oregonians have equitable access to care. 
• Ranier Simons (Community Access National Network) asked the board to exclude Odefsey from review to ensure access. 
• Silas Martin (Johnson and Johnson) asked the board to exclude Tremfya and Xarelto from the affordability review. Martin said that PBMs do not pass cost savings onto patients, and reiterated concerns about the number of drugs in the review process. Martin noted that Johnson and Johnson provides various support programs to enhance patient access to Tremfya and Xarelto. They also noted that Xarelto is subject to a maximum fair price as part of the Inflation Reduction Act.