With many state legislative sessions wrapping up in the coming weeks, we wanted to provide an update on some notable legislative activity in 2026 that we have been tracking over the last few months.

In short, several key Prescription Drug Affordability Board (PDAB) proposals have recently failed, including a governor veto alongside some bills which died in committee; however, some PDAB/transparency legislation remains actively moving through state legislatures, while similar measures in several other states remain pending or stalled as their respective legislative sessions wind down. Nonetheless, a recent judicial update is likely to spur new and enhanced state requirements.

Below are some notable updates:

• Oregon PDAB given expanded capabilities

In April 2026, Oregon updated its PDAB's capabilities by amending the PDAB's drug selection process. The amendment also expands the affordability review criteria, adding new considerations such as whether a drug has contributed to health inequities in communities of color.

• Illinois PDAB likely to be enacted

This bill (originally passed in the Senate and then passed in the House on May 21, 2026) is back in the Senate for a concurrence vote on a recent House amendment. With the legislative session adjourning on May 31, it is highly likely to reach the governor's desk, though Governor Pritzker has not yet guaranteed a signature. If enacted, this PDAB would be another example of a PDAB authorized to set upper payment limits for prescription drugs.

• Virginia PDAB (Prescription Drug Affordability Board) bill vetoed by Governor

On May 19, 2026, Gov. Abigail Spanberger vetoed legislation that would have created a state board to review prescription drug costs, saying that evidence from other states shows that such boards do not achieve the goal of lower prices.

• Bills penalizing "unsupported" or "excessive" price increases

An interestingly novel bill in Rhode Island, if enacted, would penalize pharmaceutical manufacturers for taking an "unsupported price increase" (i.e., an increase in which there was as no, or inadequate, new clinical evidence to support the price increase). To determine this, the state would rely upon analyses prepared by the Institute for Clinical and Economic Review (ICER) annual report.

The penalty in any calendar year would equal 80% of the difference between the revenue generated by sales within the state of the identified drug and the revenue that would have been generated if the manufacturer had maintained the WAC from the previous calendar year (adjusted for inflation).

Similarly, a New Jersey bill attempts to directly penalize manufacturers if a drug's WAC increases by 50% or more in a single year.

However, based on current progress, it is unlikely that either of these bills will be passed in their current form.

• Judicial update expected to further state regulation

On May 18, 2026, the U.S. Supreme Court formally declined to hear multiple pharmaceutical industry challenges to the federal Medicare Drug Price Negotiation Program. By leaving lower court rulings intact, the Supreme Court has effectively signaled a reluctance to invalidate government-negotiated drug pricing frameworks. Legal analysts note this is expected to embolden state legislatures to aggressively pursue their own PDABs and upper payment limits with less fear of constitutional challenges.

We recently presented on a hot-button topic in the world of drug pricing, "Prescription Drug Affordability Boards (PDABs): Overview, Challenges, and Recommend Strategies."  This presentation provides an informative overview for pharmaceutical manufacturers by covering the following aspects:

• The reasons why there so many PDABs being established
• The current PDAB landscape in the US
• PDAB authority & tools
• Pharmaceutical Manufacturer burdens
• Legal Challenges
• Example of affordability reviews and consequences
• Interactions of Federal and State Controls
• Next steps: What manufacturers need to think about

If you are interested in receiving a copy of the presentation, please enter your information in the contact form below and we will automatically provide you with a copy.

As reported by PolicyMed, Biohaven, a Pfizer subsidiary, recently resolved a settlement with the Department of Justice (DOJ) for nearly $60 million.  While the settlement resolved allegations of false claims related to improper physician remuneration for speaker programs, notably the case also highlighted violations of the Open Payments law for the failure to report speaker payments to CMS.

In the legal complaint, the Department of Justice stated that "Biohaven now attempts to hide the number and payments it made to speakers to cover up its quid pro quo activities. Biohaven is required by federal law to report all payments made to prescribers for the entire year in the first reporting period the following year.  Notwithstanding the actual data contained in Biohaven’s internal documents, the Company reported to CMS only approximately ten percent of the payments made to each of the speakers in order to prolong its scheme."

The significance of this claim is two-fold.  First, the DOJ used Biohaven's apparent failure to report accurately under the Open Payments law as evidence that Biohaven attempted to hide illegal arrangements with HCPs, bolstering the DOJ's false claims allegations.  Second, the failure to report likely allowed the DOJ to negotiate a larger settlement against Biohaven in light of civil monetary penalties that can be levied under the Open Payments law for failure to report accurately.

This case is yet another example of the government using Open Payments data (or the lack thereof) to strengthen the case for enforcement against life sciences manufacturers - not to mention imposing millions of dollars more in settlement amounts.  With the CY2024 report deadlines fast approaching, it also underscores the need for accurate and complete reporting under state and federal spend transparency laws, as well as the importance of viewing the data through a compliance lens prior to reporting.

On Tuesday, January 21, 2025, the Garden State officially opened the registration process for its State Price Transparency Reporting (SPTR) program.  This means that drug manufacturers who meet the reporting criteria must now register with the Drug Affordability Unity at the NJ Division of Consumer Affairs and prepare to comply with the state's drug price transparency requirements.

All reporting entities - including drug manufacturers - have a short window to register; registration is required by January 31, 2025.

To register, manufacturers must use the Excel spreadsheet template provided.  For additional guidance, you may refer to the Data Collection Manual.  While not explicitly stated in the Manual, it appears that the "entity type" for drug manufacturers should be: "Manufacturer."  Moreover, it appears that completed registration forms should be emailed to: [email protected].

As a reminder, in NJ, reporting of applicable price increases and new drugs already went into effect on August 1, 2024.

To visit the NJ registration page for more info, please see here.

2024 was a record-setting year for new State Drug Price Transparency Reporting (SPTR) requirements.  From California to New Jersey, North Dakota to Texas, Maine to New Mexico, Washington to Florida, we've seen new SPTR laws enacted in every area of the country and across the political spectrum.

But brace yourselves because 2025 is picking up right where we left off.  In fact, while we are just a few days into the new year, we already have one of our first bills in New York that is proposing new SPTR requirements (in addition to the NY law that was already enacted last year)!

Already managing perpetual SPTR requirements in 15+ states with 30+ price increase calculations (not to mention new drug notifications and similar reporting ) is enough to make your head spin.  To alleviate this burden and help avoid potential regulatory scrutiny by exceeding price increase thresholds (not to mention severe enforcement penalties which have already been levied against the industry), our clients have trusted our cost-effective reporting services and first-of-its-kind software platform, Rx Price Transparency Tracker, which provides instant analysis on drug pricing considerations and their regulatory impact.

We've started this blog to help keep the industry informed of SPTR (and Spend Transparency) reporting requirements.

Keep checking back for more updates.  In the meantime, we hope you had no issues submitting the Louisiana SPTR report and have submitted or are about to submit the other January SPTR reports, such as North Dakota, Texas, West Virginia, Maine, Pennsylvania, and California.  Good luck!