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PDAB refines drug-review rubric and reviews antidiabetic drugs; board flags data inconsistencies
Summary
Staff updated the scoring rubric and material packets for group-3 antidiabetic drug reviews (Jardiance, Manjaro, Ozempic, Rybelsus, Trulicity). Members requested clarifications on utilization cutoffs and data sources after spotting apparent unit/price inconsistencies in one chart for Ozempic.
At the Sept. 17 meeting the Prescription Drug Affordability Board continued its series of group reviews, focusing on group 3 (antidiabetics) and considering proposed updates to the scoring rubric used to evaluate whether a drug creates an affordability challenge.
Courtney Whitlock presented changes staff made to the rubric and showed sample packet tables for drugs including Jardiance, Manjaro, Ozempic, Rybelsus and Trulicity. Staff said the rubric ranges were drawn from the dataset now imported into the dashboard and that the rubric is intended as a decision-support tool rather than a mechanically binding score.
Board members praised some packet improvements but asked staff to clarify key technical points. Pharmacist and board member John Murray and others requested clearer citations or the evidence base for utilization cutoffs. Several clinicians and pharmacists flagged an apparent discontinuity in the Ozempic pricing charts: the unit-price graph showed a sharp drop in 2021 that did not align with the 30-day WAC table, prompting staff to commit to double-check sources and units and return corrected graphics.
Members also discussed pharmacy acquisition-cost (AAC) versus published WAC values and how package/unit differences (pens, boxes, dosing units) complicate apples-to-apples comparisons; board members asked staff to reconcile AAC, WAC and net-price tables and to explain how doses were converted to 30-day equivalents. Staff said they will revise the packets, add citations and present corrected tables in the November and December review sessions; the board agreed November–December will be for discussion and January reserved for final votes.
The packet included stakeholder letters for several drugs and staff noted the board will stop accepting new public surveys after next month to allow a stable packet for final deliberations.
Next meeting topics will include insulin products and continued rubric refinements prior to January votes.
