As a Louisiana resident and longtime patient advocate, I understand the frustration many families feel when we look at our pharmacy receipt. Affordability is an important arm of defining access. Unfortunately, Louisiana Senate Bill 401, which would create a so-called “Prescription Drug Affordability Board” (PDAB), risks doing real harm to patients while failing to address the true drivers of high drug costs.
SB 401 is being sold as a solution, but experience from other states tells a very different story. Eleven states have already established PDABs. Not one has saved patients or states money. Instead, these boards have consumed millions of taxpayer dollars through staffing costs, consultants, and litigation, while producing no measurable relief at the pharmacy counter. Indeed, nothing in the legislation of these bills or SB 401 would save patients or states money.
Worse, this bill is structurally flawed in ways that directly threaten patient access. The bill excludes patient representation entirely, repeating a familiar and harmful pattern in healthcare: decisions made about patients without patients. You cannot improve access for people living with serious or chronic conditions while shutting them out of the process.
The legislation relies on an overly simplistic view of “cost” by focusing on wholesale acquisition cost (WAC), a list price that does not reflect what insurers, PBMs, or government programs actually pay and a metric that the Federal Trade Commission has already found PBMs abuse and manipulate. This approach unfairly targets innovative medicines that serve smaller populations, like patients with HIV, hepatitis C, cystic fibrosis, cancer, and rare diseases, while ignoring real cost drivers like pharmacy benefit manager (PBM) practices, abusive prior authorization, and benefit designs that push costs onto patients.
We have seen this movie before. In other states, PDABs follow a clear path toward “upper payment limits,” effectively imposing supply-chain-blind price controls. These policies reduce reimbursement to pharmacies, harm rebate retention for the state’s Medicaid program, and will ultimately make it harder for patients to get the medications we need. That is why New Hampshire disbanded its PDAB, Vermont abandoned the idea of implementing a PDAB, and even Oregon’s board has openly questioned whether it should continue at all. In fact, among Oregon and Ohio’s only formal recommendations, PBM reform is the top of the list and we already have numerous bills this session to address this very issue. SB 401 is not one of those.
There is also a broader concern about how these types of policies are implemented over time. In other states, affordability boards have relied on cost-focused frameworks that can undervalue treatments for people living with disabilities or chronic conditions. Some of these approaches are similar to metrics like the “Quality-Adjusted Life Year”, or QALY, which assigns less value to treatments for those populations in order to deny coverage of those medications because “it’s not worth it”. Federal law rightly limits the use of these measures in federal programs, but SB 401 specifically seeks to import these discriminatory metrics by looking at countries that use them.
At a time when Louisiana patients are already facing pharmacy closures and increasingly restrictive insurance practices, SB401 moves our state in the wrong direction. When reimbursement is artificially constrained, or uncertainty is introduced into the supply chain, it results in delayed treatment, narrower formularies, and fewer pharmacies able or willing to stock critical medicines. For people living with HIV, hepatitis, cancer, or rare and complex conditions, even short disruptions have lifelong consequences. Any policy that risks creating those barriers cannot credibly claim to put patients first.
Louisiana lawmakers have already identified and are working toward meaningful reform around PBM accountability, benefit design reform focused on protecting patients, and transparency – areas that actually reflect how medications are paid for and accessed. SB401 does none of that.
Patients in Louisiana do not need to repeat the failed and costly experiments of other states. We need policies that expand access, protect patients, and focus on the real barriers standing between the people and our care. SB401 fails that test, and for the sake of patients, it should be rejected.
Jen Laws is President and CEO of the Community Access National Network (CANN) and is based in Slidell, Louisiana.