The Partnership to Improve Patient Care (PIPC) recently submitted a letter to the Minnesota Prescription Drug Affordability Board (PDAB) to share concerns of patients and people with disabilities related to the PDAB’s potential use of cost effectiveness analyses.
The letter stresses the importance that the PDAB be aware of existing law and regulations that bar the use of QALYs and similar measures in decisions impacting reimbursement and coverage, as well as the inherent tradeoffs among different value assessment methods. PIPC is also concerned that the Minnesota PDAB is considering a policy alternative to automatically set Medicare’s “maximum fair price” as the upper payment limit (UPL) for drugs purchased in Minnesota whose price has been negotiated at the federal level.
"The consequence of devaluing patients and people with disabilities is real, with implications for formulary placement, delayed or denied care, and increased out-of-pocket costs for patients choosing the care their doctors prescribe and that best meets their health needs even when it is not preferred by payers or health economists," wrote PIPC Chairman Tony Coelho. "We do not need more policies putting payers between decisions made by doctors and patients."
"The consequence of devaluing patients and people with disabilities is real, with implications for formulary placement, delayed or denied care, and increased out-of-pocket costs for patients choosing the care their doctors prescribe and that best meets their health needs even when it is not preferred by payers or health economists," wrote PIPC Chairman Tony Coelho. "We do not need more policies putting payers between decisions made by doctors and patients."
| pipc_minnesota_pdab_2025.pdf |
