State-level price caps? Massachusetts drug-cost pushback breaks new ground

Massachusetts is joining the state-level push to tamp down drug prices. Lawmakers are proposing new disclosures about pharma's pricing decisions, just as they are in other states. But unlike California's move to limit price increases, for instance, Massachusetts could actually cap prices on specialty meds.

As The Boston Globe reports, drugmakers would be forced to justify their pricing by laying out numbers on R&D outlays, manufacturing costs and marketing spend. And for some of the most costly drugs, state officials would have the power to limit prices.

U.S. payers are lobbying states in favor of a pricing crackdown, the Globe notes--and it's no different in Massachusetts. "We need to get under the hood and understand what goes into these prices," Lora Pellegrini, president of the Massachusetts Association of Health Plans, told the newspaper.

The lobbying efforts, led by the America's Health Insurance Plans trade group, come on top of a broader payer pushback on drug prices. Insurers and pharmacy benefits managers are working to force discounts on products in competitive drug classes, exclude certain brands from coverage altogether and raise the bar for individual coverage approvals.

In California, assembly member David Chiu unveiled a bill in February that would mandate cost disclosures for drugs priced at more than $10,000 per year. "In recent years we have seen drug costs climb to new heights with little transparency for these astronomical prices," Chiu said at the time. "With this bill, we will lift the veil on drug prices and offer the public greater insight so that we can identify meaningful strategies to ensure prices do not threaten access to life-saving treatments."

- here's the Globe story

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