Health advocacy groups back H.1092 to tie drug prices to value; industry and some patient groups warn of overreach

BOSTON — Supporters of House Bill 1092 told the Joint Committee on Financial Services the state needs new tools to evaluate whether high-priced medicines deliver commensurate clinical benefit and to hold manufacturers accountable for excessive prices.

Grace Jurkovich, policy manager at Health Care For All, testified that prescription drug spending is the fastest-growing category of health care cost and that H.1092 would allow the Center for Health Information and Analysis (CHIA) to refer high-cost drugs to the Health Policy Commission (HPC) for further review and possible publication of a proposed value. "These provisions are important because often the most expensive drugs offer no additional clinical benefit to justify their high list price," Jurkovich said.

Disability advocates supported the bill. Samantha Fine of the Disability Policy Consortium said people with disabilities are disproportionately harmed by high prescription costs and cited CDC data showing disabled adults on prescription medications are more likely to not take medication as prescribed because of cost.

Students and researchers also testified in favor. Stephanie Wang, a graduate student who cited international health technology assessment models, urged Massachusetts to adopt accountability standards used in other countries that evaluate clinical and economic value.

Opponents warned the bill's language is vague and could produce unintended consequences. Derek Flowers of the Value Care Coalition said the measure lacks clear criteria and methodology to measure value and risks prompting formulary restrictions, reduced pharmacy stocking, or increased utilization management that could harm patient access. He urged the committee to require clear, patient‑centered valuation frameworks and guardrails.

Health-plan representatives echoed those concerns and asked the committee to consider broader cost drivers. Sarah Caramita of the Massachusetts Association of Health Plans said drug costs are the largest driver of growth and that changes to how drugs are evaluated must account for impacts on premiums and plan design.

Supporters said H.1092 would not preclude patient-centered review and could create transparency and benchmarks to negotiate better prices for drugs with low added benefit. The committee did not vote on the bill and asked stakeholders to provide methodological detail on how CHIA and HPC would evaluate drug value.

Ending: The hearing highlighted strong advocacy for state tools to assess drug value and mixed views about process design; the committee requested technical follow-up on evaluation methodology and consumer protections.