Michigan Dems renew push to cap rising drug prices with new oversight board

New legislation aims to create a Prescription Drug Affordability Board to cap costs, hold pharmaceutical companies accountable, and address a crisis that’s affecting nearly one-third of Michiganders.

LANSING—Millions of Michiganders who are struggling to afford their prescription medications may soon find some relief through recently introduced state legislation that’s aimed at capping the prices of some of the most commonly prescribed drugs in the state of Michigan.

Democratic lawmakers in the state Senate this month filed three bills that aim to create a Prescription Drug Affordability Board (PDAB)—an independent entity that would have the legal authority to set new maximum price limits on whatever prescription drugs it decides to review.

State Sen. Darrin Camilleri (D-Trenton) said the legislation—Senate Bills 3, 4, and 5—was designed with a simple mission: to prevent big pharmaceutical companies from continuously jacking up the price tags on their drugs in the state, often at the expense of sick Michiganders.

“This is one tool to hold them accountable,” Camilleri told The ‘Gander. “The point is that we need to do something, and this is one idea. Let’s start a conversation about other ideas to hold Big Pharma accountable and really rein in these exorbitant profits and high costs of medicine.”

Here’s the deal:

The PDAB would be tasked exclusively with lowering drug costs in Michigan—namely by setting new “upper payment limits” on the most popular and expensive prescription drugs statewide.

The new, five-member board would be appointed by the governor, “with the advice and consent” of the state Senate, and would consist of experienced professionals in health care economics, health policy, health equity, and clinical medicine—with no ties to the pharmaceutical industry, in a move designed to ensure both impartiality and transparency in setting the new price caps.

The legislation would also create a 21-member advisory council to guide the board—which would include representatives from drug manufacturers, hospitals, insurance companies, and pharmacies, as well as representatives from other statewide organizations that focus on several specific issues—like promoting racial diversity and advocating for the state’s senior citizens.

All of the board’s meetings would be open to the public. And within 18 months of the legislation being signed into law, the board would specifically be tasked with identifying and setting a set price cap on at least one generic drug that costs Michiganders at least $100 for a 30-day supply. 

More specifically, the legislation also calls for these upper payment limits to be set when the board finds that spending on a particular prescription drug has led to (or will lead to) “affordability challenges to health care systems” or “high out-of-pocket costs for patients.”

And anytime Big Pharma wants to hike prices on one of its drugs in Michigan, the board would need to sign off on the increase—much like the state Public Service Commission has the authority to approve or reject rate increases from the state’s utility companies, Camilleri said.

“Pharmaceutical companies set these prices. They know that insulin costs pennies to make, but they still charge hundreds of thousands of percentiles more than what it should be,” Camilleri said. “That’s something that impacts everyday Michiganders. And that’s a big problem.”

So what?

Research shows that one in three Michiganders have stopped taking their potentially life-saving medication as prescribed due to the rising cost of prescription drugs. Meanwhile, the pharmaceutical industry reported $29 billion in net profits during the first three months of 2024.

Camilleri said it’s time to level the playing field for Michigan families—specifically for older adults, who have disproportionately struggled to afford their medication costs in recent years. 

“People are literally making choices about their budgets based on whether or not they can afford medicine,” Camilleri said. “They’re either forgoing food or forgoing utility bills to pay for medicine, or they’re halving the dosage of their medicine to afford their household bills. That’s an unsustainable system that directly impacts too many of our neighbors across the state.”

If the legislation passes, Michigan would join at least six other states that have taken similar measures to cap prescription drug prices. And Camilleri would like to get the board in motion quickly because the process can be slow; Maryland and Colorado were among the first to form their own PDABs years ago—and they have yet to set a price limit on a single prescription drug.

“Regardless of your political ideology, taking on Big Pharma should not be a partisan issue,” Camilleri added. “Everybody, whether you’re a Republican or Democrat, is facing high prices.”

Bills to create a PDAB passed the state Senate last year and stalled in the House. But Camilleri and co-sponsoring state Sens. Veronica Klinefelt (D-Eastpointe) and Sue Shink (D-Northfield Township) reintroduced them this year with a fresh eye toward bipartisan support.

“Everyone should be able to afford the prescription drugs they need,” Shink said in a statement. “This legislation is a big step toward staying healthy, more affordable in Michigan.”

Added Klinefelt: “Michiganders shouldn’t have to choose between affording critical medications or paying for rent and groceries. It’s time to rein in these out-of-control costs for residents.”

Why now?

Dr. Rob Davidson, executive director of the Committee to Protect Health Care, brings nearly three decades of experience as an emergency room physician in rural West Michigan and has witnessed firsthand the toll that skyrocketing drug prices have had on his patients’ lives.

“I honestly see it every day,” Davidson told The ‘Gander. “I mean, we don’t have direct conversations about it every single shift that I work, but it certainly comes up quite often.”

Davidson recounted treating one patient who ended up in the emergency room simply because they were unable to afford the cost of picking up their prescription inhaler at the pharmacy—a situation that Davidson described as entirely avoidable, had prices only been more affordable.

Another patient with a blood clot needed Eliquis, an expensive but life-saving blood thinner. Unable to afford it, he ultimately was forced to rely on coupons to cover his 30-day supply—and now has no immediate plans to pick up a refill unless more coupons become available.

“You keep hearing it more and more because the costs keep going up and up,” Davidson said. “Either they don’t take their medication or they get routed into some older drug that is less safe.”

Davidson also described broader consequences of unaffordable drugs beyond declining physical health—including the emotional trauma of choosing between paying the bills or covering healthcare treatment, which can, in turn, jeopardize patients’ mental health.

“It’s definitely connected. If they can’t manage their physical health to the best of their ability, that has a negative impact,” Davidson said. “It causes people to go into debt. That can lead to housing insecurity. Their nutrition can suffer. These costs can impact every aspect of their life.”

According to Davidson, the PDAB’s proposed structure—independent experts without any direct ties to the pharmaceutical industry—is key to its success. He also said that passing the legislation would lead to natural efficiencies for health care providers across the state.  

“We won’t be pulled away to come up with workarounds,” Davidson said. “Part of the burnout [in the healthcare field] isn’t just about long hours and paperwork. But a lot of it is the moral harm where we see patients suffering unnecessarily and we see an industry like Big Pharma raking in billions and billions of dollars while our patients are living on the edge, paying the price.”

Davidson also urged Michiganders to make their voices heard this month—specifically by calling their state lawmakers in the state House and Senate and encouraging them to pass the bills.

The legislation has been assigned to a Senate Committee and will eventually need to pass through the Democratic-controlled state Senate and the Republican-controlled state House if it has any chance of making it to Gov. Gretchen Whitmer’s desk to be signed into law this year. 

“I don’t know how any of the silliness happening in Washington or Lansing lowers the price of eggs, but they certainly have a clear opportunity to lower the price of prescription drugs,” Davidson said. “This is about lowering costs. This should be a nonpartisan issue for everyone.”

READ MORE: Michigan Dems pursue legal action against Republicans over blocked bills

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