Why the Drug Industry Fights So Hard Against Boards It Claims Don’t Work

By ALDP Co-founders Michael Glassner and Jason Young

Drug prices are one of the few things Americans agree on anymore. President Trump has made them a target. So has Bernie Sanders.

In Louisiana, a bill to create a Prescription Drug Affordability Board just made it through the legislature, passing the state Senate 36-0 and the House 88-7. The pharmaceutical industry increasingly finds itself isolated on this issue.

Its response has been consistent. Prescription Drug Affordability Boards don’t work, the industry says. Other states tried them and failed. Don’t repeat their mistakes.

The pharmaceutical industry has spent heavily promoting that argument.

It does not hold up.

Most state boards were built as transparency tools. Their job was to document whether specific drugs are unaffordable and to examine why. They are doing that. Calling them a failure is like calling a smoke detector a failure because it didn’t put out the fire. Only four states – Colorado, Maryland, Washington, and Minnesota – have given their boards authority to limit what patients, pharmacies, employers, and health plans can be charged for certain drugs. Those are the boards designed to lower prices directly.

A Fabrizio-Ward survey found that 87% of Trump voters and 96% of Harris voters consider high drug prices a top health concern and say legislative action is important. They are responding to something real: Americans pay two to four times more for the same drugs, made by the same manufacturers, than patients in other developed countries.

The industry’s response has often been litigation. In Oregon, it sued over a state drug-pricing transparency law – one with no authority to cap what anyone pays. It won at the district court. The Ninth Circuit reversed, upholding the law. PhRMA has since petitioned the Supreme Court to take the case. In Colorado, the manufacturer Amgen sued twice to block a single payment limit on a single drug, the second lawsuit coming after a federal court dismissed the first.

That is not how industries behave when they believe a policy is irrelevant.

There is a contradiction at the heart of the industry’s position. We are told these boards are ineffective, inconsequential, and incapable of accomplishing anything meaningful. Yet manufacturers and their trade associations continue to devote extraordinary resources to opposing them in legislatures and courts across the country. Those two claims cannot both be true.

In Louisiana, overwhelming legislative support made direct opposition politically difficult. So the debate shifted to the details. Industry-backed amendments sought to eliminate most reporting requirements, weaken enforcement provisions, and deflect scrutiny altogether – going so far as to remove the term “Affordability” from the board’s name. Fortunately, the conference committee preserved the bill’s core transparency mission, and lawmakers ultimately passed a board with meaningful reporting requirements and real consequences for companies that refuse to comply.

Importantly, many of the industry’s criticisms of PDABs are directed at powers Louisiana’s board does not possess. Louisiana’s legislation does not set prices, impose reimbursement limits, or restrict access to medicines. It asks manufacturers to provide information and explain their pricing decisions. That is a much narrower proposition than many opponents would have the public believe.

It is worth asking why any of this machinery is necessary in the first place. Manufacturers set these prices. They could lower them. They have chosen not to.

So Americans for Lower Drug Prices will continue its work, in Louisiana and beyond.

The bill now heads to Gov. Jeff Landry, whose administration has made healthcare transformation and affordability important priorities. If signed into law, Louisiana’s board would demonstrate something important to other states: transparency is not a partisan idea, and accountability is not a radical idea.

It would also mean the industry’s arguments are not as powerful as its lobbying budget. They are not.