The Board will study of the entire prescription drug distribution and payment system in Oregon and polices adopted by other states and countries that are designed to lower the list price of prescription drugs including:
- Using a reverse auction marketplace for the purchase of prescription drugs by state and local governments.
- Implementing a bulk purchasing process for state and local governments to purchase prescription drugs.
Based on information provided to the board by the Drug Pricing Transparency (DPT) program, it will identify nine drugs and at least one insulin product that it determines may create affordability challenges for health care systems or high out-of-pocket costs for patients in this state based on criteria adopted by the Board.
This criteria will include, at a minimum:
- Whether the prescription drug has led to health inequities in communities of color;
- The number of residents in Oregon prescribed the prescription drug;
- The price for the prescription drug sold in Oregon;
- The estimated average monetary price concession, discount or rebate the manufacturer provides to health insurance plans in Oregon or is expected to provide to health insurance plans in Oregon, expressed as a percentage of the price for the prescription drug under review;
- The estimated total amount of the price concession, discount, or rebate the manufacturer provides to each pharmacy benefit manager registered in Oregon for the prescription drug under review, expressed as a percentage of the prices;
- The estimated price for therapeutic alternatives to the drug that are sold in Oregon;
- The estimated average price concession, discount, or rebate the manufacturer provides or is expected to provide to health insurance plans and pharmacy benefit managers in Oregon for therapeutic alternatives;
- The estimated costs to health insurance plans based on patient use of the drug consistent with the labeling approved by the U.S. Food and Drug Administration and recognized standard medical practice;
- The impact on patient access to the drug considering standard prescription drug benefit designs in health insurance plans offered in Oregon;
- The relative financial impacts to health, medical, or social services costs as can be quantified and compared to the costs of existing therapeutic alternatives;
- The estimated average patient copayment or other cost-sharing for the prescription drug in Oregon;
- Any information a manufacturer chooses to provide;
- Any other factors as determined by the Board or in rules adopted by the Board.