Drugs selected for an affordability review are published on the board's website before initiating the affordability review.
(1) When conducting an affordability review, the board will consider:
- (a) The relevant factors contributing to the price paid for the prescription drug, including the wholesale acquisition cost, discounts, rebates, and other price concessions;
- (b) The average out-of-pocket cost for the drug;
- (c) The effect of the price on consumers' access to the drug in the state;
- (d) Orphan drug status;
- (e) The dollar value and accessibility of patient assistance programs offered by the manufacturer for the drug;
- (f) The price and availability of therapeutic alternatives;
(g) Input from:
- (i) Patients affected by the condition or disease treated by the drug; and
- (ii) Individuals with medical or scientific expertise related to the condition or disease treated by the drug;
- (h) Any other information the drug manufacturer or other relevant entity chooses to provide; and
- (i) The impact of pharmacy benefit manager policies on the price consumers pay for the drug.
(2) In performing an affordability review of a drug the board may consider the following factors:
- (a) Life-cycle management;
- (b) The average cost of the drug in the state;
- (c) Market competition and context;
- (d) Projected revenue;
- (e) Off-label usage of the drug; and
- (f) Any additional factors identified by the board.
- (3) All information collected by the board or the authority under this section is not subject to public disclosure under chapter 42.56 RCW.
[Statutory Authority: RCW 41.05.021, 41.05.160, chapter 70.405 RCW, and 2022 c 153. WSR 24-02-078, § 182-52-0045, filed 1/2/24, effective 6/10/24.]