After Youngkin’s Veto, Lawmakers Hope Spanberger Will Warm to Cost-Cutting Prescription Drug Board

A multi-year attempt to create a Prescription Drug Affordability Board in Virginia will face a new test in 2026.

The bipartisan proposal would create a special board of medical and health experts tasked with analyzing data to set payment limits on drug prices. Virginia would become the 12th state to have such a board if the law were to pass, but the concept is still novel and has drawn skepticism from a diverse range of opponents, including outgoing Gov. Glenn Youngkin.

When Youngkin vetoed the bill last year, he called it “noble in intent” but suggested it could hinder medical innovation or discourage certain pharmaceutical companies from putting down stakes in the state.

Other opponents, typically pharmaceutical manufacturing lobbyists or trade associations, have pointed to how Maryland’s PDAB has taken years to be fully operational after becoming the first state in the country to establish one in 2020.

Virginia AARP and Freedom Virginia ,an affordability-focused advocacy group, have backed Virginia’s PDAB proposal each year and touted its potential as a key factor in reducing drug prices. Meanwhile, life sciences trade group Virginia Bio director John Newby called PDABs an “unproven experiment,” in a statement celebrating Youngkin’s veto last year.

Late in 2025, however, Colorado’s PDAB became the first state to approve a cap on a drug.

By capping the cost of a medication called Enbrel, which is used to treat autoimmune diseases, starting next year a ceiling will exist for how much a patient or insurer in the state has to pay for it. That vote had been years in the making and staved off a previous legal challenge.

While the news of Colorado’s board setting a cap could spell success, the matter continues to be litigated.

The board has most recently been sued for the second time by the company that manufactures Enbrel, with its first hearing supposed to happen this month — a full year before the price cap would kick in.

The previous suit, filed when the board was still deliberating a cap on Enbrel, was dropped because the plaintiffs were not able to prove the board would cause damages.

And Maryland, Virginia’s neighbor to the north, is another state with a PDAB catching national attention.

As the first state to kick off PDABs nationwide, Maryland has served as an example of timely innovation as prescription drug prices have surged as well as a cautionary tale for states seeking a speedy solution, due to the time it’s taken to get off the ground.

The stalled journey, however, was due to various factors. After passing legislation to create it in 2019, the 2020 COVID-19 pandemic spurred then-Gov. Larry Hogan to pull the board’s earmarked funding and not assign board members.

When current Gov. Wes Moore started to get the ball rolling again by releasing those funds, the board then took a year and a half to set up a regulatory framework before settling on six drugs to consider for cost reduction. But the matter is not a done deal yet.

Maryland Matters reporter Danielle Brown, who has covered the state’s PDAB in recent years, noted that Colorado’s action “is pretty encouraging for a lot of the supporters.”

But she said opponents are “seeing this five-year lapse (in Maryland taking action) as kind of a sign that this is a lot of time, a lot of money that may not yield much in terms of out-of-pocket costs for consumers.”

But the savings to consumers are “yet to be seen,” she added, and can be a test for Maryland and other states that have enacted or are considering creating boards.

Virginia Gov.-elect Abigail Spanberger is still cautiously monitoring PDABs nationwide as a proposal here could make its way to her desk.

The matter was absent from her health care affordability platform and she did not endorse the idea on the campaign trail.

“I want to make sure that whatever we might implement in the future will be a best practice based on the successes or challenges that other states have faced,” she told The Mercury last year when asked what she thought about the PDAB proposal.

When reached last week about the subject, her staff indicated the sentiment from last summer’s comment remains the same.

Still, state lawmakers plan to try again on their PDAB proposal in this year’s legislative session. Sen. Creigh Deeds, D-Charlottesville, and Del. Karrie Delaney, D-Fairfax, will carry the bills again.

“The problem is that the concept is just beginning to show progress in other states,” Deeds said, acknowledging some people’s skepticism.

But that progress also signals how the model can work.

Deeds said this year’s version of the bill could have a specific focus on drugs to treat rare diseases, for which medications can sometimes be most costly. Ultimately, Deeds hopes that Virginia’s PDAB, if it becomes a reality, can be successful and provide relief.

“I want a bill that’s going to work and bring down costs. I think (Spanberger) does too,” he said.

Virginia Mercury is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Virginia Mercury maintains editorial independence. Contact Editor Samantha Willis for questions: info@virginiamercury.com.