The Baltimore Sun Online Article – October 22, 2025

Six years ago, Maryland made national headlines by creating the first-ever Prescription Drug Affordability Board (PDAB) — a move celebrated as a bold step toward lowering drug prices. But today, the results are clear and disappointing: the PDAB hasn’t reduced the cost of a single prescription.

Instead of helping patients afford their medications, the PDAB has created more bureaucracy, added confusion, and ignored the real drivers of high drug costs.

The Promise vs. The Reality

The PDAB was designed to give families relief at the pharmacy counter. However, despite years of hearings and meetings, prescription costs remain as high as ever.

The board’s primary tool — an “upper payment limit” — sounds promising on paper but misses the mark in practice. This approach fails to address the true causes of high out-of-pocket costs, such as:

• Skyrocketing insurance deductibles

• Complex coinsurance rules

• Lack of transparency among pharmacy benefit managers (PBMs)

By targeting list prices instead of the system’s deeper flaws, the PDAB has fought the wrong battle — leaving Marylanders to pay the price.

Ignoring Patient Realities

A recent survey revealed that even patients paying as little as $0 to $10 a month often find their medications unaffordable. Why? Because of insurance design, billing hurdles, and benefit restrictions — not the sticker price of the drug itself.

Every patient who stopped taking medication due to cost cited insurance barriers, not list prices. Yet, the PDAB continues to focus on theoretical price controls instead of tackling what truly limits access.

Doctors are warning of the consequences. Nearly 90% of Maryland specialists say the PDAB’s approach could restrict treatment options and make it harder to care for patients effectively.

Patients Left Out of the Conversation

Beyond its policy missteps, the PDAB’s process has been opaque and exclusionary. Many patients and providers say public meetings are inaccessible and decisions are hard to understand.

The board’s actions often feel like they happen to patients — not for them. That’s the opposite of what affordability reform should look like.

Lessons From Other States

Maryland is not alone in learning this lesson. New Hampshire recently repealed its own PDAB after five years of wasted effort and zero patient savings. In Colorado, even health plans now warn that “upper payment limits” could create more red tape than relief.

Maryland shouldn’t repeat these costly mistakes. It should pivot — now — toward strategies that truly help patients afford care.

The Human Cost of Inaction

This debate isn’t just about policy. It’s about health equity and access to life-saving treatment.

Maryland’s African American communities face the highest burdens of chronic disease — including heart disease and hypertension. In Baltimore City, Black residents account for nearly three-quarters of all heart disease deaths. Nationally, Black Americans are 20% more likely to have high blood pressure and less likely to have it under control.

These communities don’t need more bureaucracy. They need direct support, fair reimbursement, and access to trusted local care.

Real Solutions for Affordability

The path forward lies not in more regulation, but in reform that targets what truly drives costs. Maryland should:

• Increase PBM transparency to stop hidden markups and clawbacks.

• Simplify insurance design so patients can afford essential medications.

• Support community-based care models that prioritize patients over profits.

• Expand patient assistance and access programs in high-need areas.

At RescueMeds, we see these challenges every day. Injured workers and patients with chronic conditions are often stuck between insurers, PBMs, and state bureaucracy. We believe in real solutions — not red tape.

The Bottom Line

After six years, the verdict is clear: Maryland’s PDAB has failed to make prescription drugs more affordable. It’s time for real reform that lowers out-of-pocket costs, safeguards access to essential treatments, and closes the health equity gap.

Marylanders deserve better — affordable prescriptions, transparent systems, and healthcare that works for people, not against them.

RescueMeds’ Perspective

At RescueMeds, we believe transparency, fair reimbursement, and patient-first policies are critical to fixing the broken pharmacy system. Injured workers—already vulnerable—face unnecessary barriers created by PBMs and corporate middlemen.

Our mission is clear: deliver medications directly to patients quickly, at no cost to them, and without PBM interference. We believe trust in healthcare starts with transparency—and patients deserve nothing less.

Join us today.  Sign the Petition, send us your email and let’s hold PBMs accountable by requiring transparent costs and keep local pharmacies in our neighborhoods.