This overview is excerpted from Manatt on Health, Manatt’s subscription service that provides in-depth insights and analysis focused on the legal, policy and market developments.

On August 21, Oregon’s Prescription Drug Affordability Board (PDAB) reviewed a draft upper payment limit (UPL) constituent engagement report, which captured feedback from patients, providers, health plans, manufacturers, and other entities on the potential impacts of a UPL. Some constituents expressed concern that UPLs could limit patient access to needed medications, increase patient cost-sharing, and lead to financial losses for health care organizations and urged the PDAB to carefully consider these potential impacts when developing their final UPL policy recommendations.  

PDAB staff will next develop a conceptual outline to guide decision-making for the PDAB’s final report recommendations. The outline will include additional details on how the PDAB may establish and implement UPLs and what legal authorities and resources may be required for UPL implementation. Staff will consider UPL methodologies from other states and evaluate whether additional stakeholder outreach is needed. The PDAB will review the outline during their next scheduled meeting on September 18 and aim to finalize a full report for submission to the legislature during its November 20 PDAB meeting.