With the approval of the Virginia General Assembly, a bill reducing prescription drug prices is sitting on Gov. Glenn Youngkin's desk.

The bill establishes a prescription drug affordability board as an independent body evaluating drug price increases. A drug manufacturer can state its case for the cost increase before the board. But, if the increase is unfounded, the board could set a price on the drug for all Virginians to pay.

Jared Calfee, state advocacy director for AARP Virginia, said it is a first step, but there is no silver bullet to curb high prescription drug costs.

"This board would be looking to set an upper payment limit for up to 12 drugs," Calfee explained. "We're not going to completely solve the problem of prescription drug affordability overnight but it would make a real difference in the lives of a lot of people. And so, this is a first step and there are certainly going to be more things to do, more things to take a look at."

Drug companies have pushed back, saying the law will discourage research and development, or reduce access to medicine. But Virginians across party lines and age groups support drug affordability. Should the bill pass, Virginia would be the tenth state where prescription drug prices undergo an affordability review.

The real-world impacts the bill will have will vary from person to person and drug to drug.

Mara Shapiro is a patient advocate with Crohn's disease. Her medication, Stelara, costs more than $20,000 per dose, but she's on a copay assistance program to help offset the cost. Maintaining the program can be laborious and poor transparency can cause Shapiro delays in getting her medicine.

"It's just an unnecessary stressor or burden to already having multiple life-threatening chronic health conditions," Shapiro pointed out. "It's just frustrating that the cost for this one medication is so astronomically high that it makes it so much more difficult for me to obtain the medication every month."

AARP data showed the prices for the top 25 Medicare Part D drugs tripled since they were introduced, including Stelara. Since going to market in 2009, the drug's price shot up 184%. If it was on the same track as the Consumer Price Index, it would have only increased 41% by 2023.

After more than 50 years of use, some Michigan lawmakers say naloxone may not be the best choice in an overdose situation.

Naloxone is sometimes called the "Lazarus drug" because of its powerful ability to seemingly resurrect people after a drug overdose.

Sen. Kevin Hertel, D-St. Clair Shores, and some of his colleagues have introduced a bill which would open the door for what they say are more costly, but more powerful, antidotes.

"Given the prevalence of fentanyl in our communities, and how much stronger some of these drugs that we're now seeing are, we believe -- and in talking with others -- that there should be other tools to respond to an overdose," Hertel explained. "To make sure we're doing everything we can to save somebody's life."

Not everyone is on board with the proposed legislation, Senate Bill 542. Opponents argued the more expensive naloxone alternatives are not necessary, and using them would only increase profits for the pharmaceutical industry.

Jonathan Stoltman, director of the Opioid Policy Institute in Grand Rapids, said while the naloxone alternatives do help in overdose situations, they can also cause nasty side effects.

"The newer approaches, they put people into more severe withdrawal," Stoltman pointed out. "That's a pretty profound negative side effect. The one approach is very inexpensive and works great; the other approach is far more expensive and has this strong negative side effect."

Sponsors of the bill say they're hoping to give Michigan residents a chance to chime in on the issue in a public hearing sometime in June. Michigan saw more than 3,000 opioid overdose deaths in 2021.


get more stories like this via email

New Mexico saw record enrollment numbers for the Affordable Care Act this year and is now setting its sights on lowering out-of-pocket costs - those not reimbursed by insurance. More than 56,000 New Mexicans are enrolled in a medical health insurance plan on the state exchange - an increase of 12,000 people overall.

Colin Baillio, deputy superintendent with the state's Office of Insurance, said the state has boosted its outreach and made efforts to improve the overall consumer experience.

"We saw a 40% year-over-year increase, and New Mexico saw the biggest percentage increase during the open-enrollment period among all of the state-based marketplaces," he explained

Part of the enrollment increase is due to what's called the "unwinding" - a federal directive that required all states to redetermine Medicaid eligibility following a three-year pause on checks during the COVID pandemic. He said by using expanded tools made available by the federal and state government, 8% of New Mexico's population is now uninsured - down from 23% in 2010.

Following approval by lawmakers in the 2024 legislative session, the New Mexico governor signed seven health care-related bills into law - one of which requires annual reporting of prescription drug pricing. Baililo said the Affordable Care Act built the foundation that has allowed the state to pursue additional affordability initiatives.

"I'm really glad to see that there's so much interest in the next step of health reform, really leaning into these out-of-pocket cost issues and making it easier for people to afford to stay covered and see their doctors," he continued.

Two years ago, the state also passed a one-of-a-kind law that did away with behavioral health co-pays for people in certain insurance plans.

New York's medical aid-in-dying bill is gaining further support. The Medical Society of the State of New York is supporting the bill. New York's bill allows terminally ill people with only six months to live to use this option, with safeguards requiring two physicians' approval.

The bill's Assembly sponsor Amy Paulin, D-Westchester, said despite the growing support, other hurdles lie ahead.

"Now we have what I believe, if it came to the floor, a majority. There's still a hesitation on the part of leadership. You know, we need members to assure leadership that they no longer have reservations," she said.

Other newly resolved concerns center on making sure insurance companies and doctors who don't support this aren't held liable. She's optimistic the bill will pass after nine years in the Legislature. New York would be the 11th state along with Washington, D.C. to have medical aid in dying legislation.

Corinne Carey, senior New York campaign director with Compassion and Choices finds the pandemic drew a vivid picture of a person's end-of-life experience. There were images of people dying on ventilators, apart from loved ones, and unable to communicate. She said people began thinking about a "good death."

"And, what is a good death is being surrounded by loved ones, having some measure of control, experiencing the touch of your loved ones, and being the one in the driver's seat," she explained.

Now people have different options for end-of-life care, each of which presents various challenges. Polls show medical aid in dying has garnered considerable support since being introduced in 2015. A 2022 Compassion and Choices poll finds 57% of nurses support medical aid in dying professionally, although fewer support it personally.