After five years of attempts, Virginia on track to set up a Prescription Drug Affordability Board

A five-year journey to establish a Prescription Drug Affordability Board in Virginia reached a new milestone this week, as the proposal cleared the legislature with near-unanimous votes and strong bipartisan support. 

Senate Bill 271 passed the House Tuesday and House bill 483 passed the Senate Wednesday. The bills will establish an advisory panel to examine data and ensure that federal drug pricing caps are applied to state-regulated health insurance plans if signed into law. 

Del. Karrie Delaney, D-Fairfax, and Sen. Creigh Deeds, D-Charlottesville, have carried versions of the bill in recent years. They initially sought to create a special board of medical and health experts that would set payment limits on drugs. As the proposal evolved, it took on a new name — the “Affordable Medicine Act.”

Delaney explained that her bill is modeled after federal actions endorsed by both Presidents Joe Biden and Donald Trump’s administrations to limit prices on a handful of prescriptions to Medicare recipients. 

“Nearly 200,000 Medicare enrollees in Virginia are already benefiting from these lower prices. We’re simply now extending that,” Delaney said Tuesday. 

With federal government approvals already applying to 10 drugs since the beginning of this year, another 15 are expected to take effect next year. 

The proposal was one of the more controversial pieces of legislation considered during this year’s session. Republican lawmakers and other critics said 11 other states have created PDABs — with little to show for it.

After Maryland became the first state to establish one in 2019, its progress was stalled in part from the COVID-19 pandemic. Colorado’s board in 2025 became the first to approve a payment limit and has since been mired in lawsuits from a pharmaceutical manufacturer. 

Virginia’s Democrat-led proposal has evolved in recent weeks with input from skeptics across the aisle and feedback from Gov. Abigail Spanberger, who’d stopped short of endorsing the idea before she was elected. 

Former Gov. Glenn Youngkin vetoed PDAB proposals two years in a row, calling Delaney and Deeds’ idea “noble in intent” but cautioning it could stifle pharmaceutical innovation in the state. 

Republican lawmakers with pharmaceutical backgrounds who had bucked the bills showered them with praise in the House of Delegates on Tuesday. 

Murmurs of surprise and support echoed through the chamber when Del. Keith Hodges, R-Middlesex, rose to announce he planned to vote for the final passage of the bill. Brunswick Republican Del. Otto Wachsmann’s declaration that he was changing his planned no vote to a yes drew a robust round of applause. 

Hodges said that the legislation can enhance drug pricing transparency at multiple steps in the process, from manufacturing to distribution to consumers acquiring them. 

Delaney previously told The Mercury that she hopes her bill can help explore root causes in drug supply chains that factor into higher prices. 

“On a bigger scale, it’s about understanding why (drug price surges) happen and who is accountable,” Delaney said. “Somewhere along the supply chain if we can identify ‘hey, this is where we’re seeing these jumps happen’ that gives us a precision approach at addressing costs for drugs.”

Delaney is among lawmakers in both parties to have relayed anecdotes from constituents who have felt forced to choose between medicine they need, paying their rent or mortgages, and being able to buy groceries for their families. 

“This really is the culmination of a tremendous amount of work, years of work,” she said. “We’re going to lead the way in Virginia.”

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