ANNAPOLIS, Md. (7News) — Maryland is moving ahead with a first-in-the-nation effort to limit how much state and local government health plans pay for high-cost prescription drugs like Ozempic — a move supporters say could save taxpayers millions, but critics warn may create new hurdles for patients seeking treatment.
The decision came this week after the Maryland Prescription Drug Affordability Board voted to advance a proposed payment cap on Ozempic, the widely used diabetes and weight-loss medication manufactured by Novo Nordisk.
Supporters of the proposal argue that the soaring cost of GLP-1 medications has become unsustainable for government-funded health plans. State officials estimate the proposed cap on Ozempic alone could save nearly $6 million annually. The board previously approved a similar cost cap on Jardiance after determining the drug was considered “unaffordable” under Maryland law.
Under the proposal, the state would set what is known as an “upper payment limit” for certain government health plans, including plans covering state and local employees. The limits would not apply to private insurance plans or individual consumers directly.
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However, the plan has sparked concern among patient advocacy organizations and pharmaceutical industry representatives, who argue the policy could unintentionally restrict access to medications by prompting tighter prior authorization requirements or other insurance coverage limitations.
The proposal is not yet final. It now enters a 30-day public comment period, and any payment caps would not take effect until at least next year.
Vincent DeMarco, president of the Maryland Citizens’ Health Initiative, praised the board’s action and said the effort is aimed at improving affordability for patients.
“Drugs don’t work if people can’t afford them,” DeMarco said. “This is all about patient access and patients being able to afford their drugs.”
Maryland’s Prescription Drug Affordability Board was created in 2019 and has drawn national attention as states across the country search for ways to control rapidly rising prescription drug costs, especially for popular GLP-1 medications increasingly used for both diabetes treatment and weight loss.
Meanwhile, Maryland officials are also exploring a subscription-style payment model for GLP-1 drugs as another potential strategy to control long-term costs while expanding access to patients.
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