Health Care & Wellness
Prescription Drug Affordability Boards Face Legal Challenges as States Tackle Drug Costs
February 25, 2026 | Mary Kate Barnauskas
Virginia's Senate passed legislation to establish a Prescription Drug Affordability Board with upper payment limit authority, marking the third attempt in three years under new Governor Abigail Spanberger. PDAB upper payment limits allow states to cap what purchasers and payers can be required to pay for select high-cost drugs, with Colorado becoming the first state to implement one in October 2024. Four states now have PDABs with upper payment limit authority, and recent Virginia PDAB legislation follows a trend of using the Medicare maximum fair price as a benchmark for setting drug cost caps. State drug pricing policy through PDABs faces legal challenges in Colorado, where a manufacturer argues that upper payment limits conflict with federal authority and violate due process.
