On June 6, 2024, The Global Coalition on Aging (GCOA) Alliance for Health Innovation convened a roundtable discussion of cross-sectoral experts representing patients, caregivers, academia, biopharmaceutical innovators, and business communities to discuss Prescription Drug Affordability Boards (PDABs), Upper Payment Limits (UPLs), and the risk they pose to the innovation that is needed to safeguard healthy aging and improve health equity.

This brief builds on two previous GCOA Alliance for Health Innovation policy briefs—the first from June 2023 on healthy aging and innovation, and the second from September 2023 on the intersection of healthy aging, innovation, and oncology – and highlights the themes that emerged from the roundtable discussion, including patient concerns with PDABs and recommended best practices for patient engagement in States that have implemented or are considering the implementation of PDABs and UPLs.

Key Takeaways:

1. The ability of PDABs and UPLs to create savings is unproven. PDABs have only a singular tool that can set prices for drugs deemed unaffordable – UPLs, which are more aligned with systems-level cost containment strategies, without ability to pull through to any patient savings at the pharmacy counter.
2. PDABs’ affordability review processes can introduce health equity concerns by limiting access to critical drugs and therapeutics, disproportionately impacting patients who are managing hard-to-treat conditions and aging populations.
3. Implementation of UPLs is likely to stagnate future innovation. Our country’s rapidly growing aging population needs solutions that promote innovation that aids healthy longevity, rather than policies that threaten patient outcomes and increase the demands on our healthcare system.
4. Patients and advocates want to engage with PDABs and their decision-making, and must be meaningfully engaged. Incorporating diverse patient voices and perspectives into the engagement process and ongoing feedback loop surrounding the affordability review of any specific prescription medication is essential to mitigate the united impacts on patients and other disruptions to the complex pharmaceutical supply chain.

The Global Coalition on Aging Alliance for Health Innovation brings together over 20 patient advocacy organizations, scientists, and policy specialists to establish awareness of the importance of innovation in achieving healthy aging through investments, policy reforms, and strategic partnerships – both for the value to patients and for health system sustainability.