PHARMACEUTICALS Facts Policies and NCSL Resources

PHARMACEUTICALS: Facts, Policies and NCSL Resources

Table of Contents

Updated: April 2015

AT A GLANCE:  Prescription drugs continue as one of the more active health policy issues in 2014.  NCSL has followed the state aspects of these issues for a number of years.

As reported in 2012, Americans spend more than $271 billion dollars on prescription medicines annually. Total spending on drug therapy total about $300 billion dollars, including over-the-counter (OTC) drug remedies,valued at 31 billion.

*NEW* 2015 Prescription Drug Legislation Database  - NCSL has just launched its state legislation online database, tracking major policies affecting prescription drugs and biologic medicines. The new feature allows policymakers to view more than 730 filed bills across all 50 states and D.C., according to specific topics such  pharmaceutical patient access and affordability, specialty pharmaceuticals, compounding pharmacy regulation, Medicaid and health insurance coverage and reimbursement, and the right-to-try investigational drugs for the terminally ill. This first-in-the-nation state resource is available to all NCSL members, including the full text of any bill.  All users, including the public, can search by state, bill status, and any of 10 topics, using simple check boxes.

Map of 2015 prescription drug state enacted laws by NCSL

National Health Expenditures: Prescription Drugs

In April 2014, three commercial pharmaceutical surveys and reports, released in a 10 day period, revealed latest details of prescri[ption drug spending for 2013. 

In Sept. 2013 a Health Affairs Web article provided an updated perspective on where spending is for prescription drugs now and through the next 10 years. The actuaries from CMS stated, "In 2012 prescription drug spending is estimated to have accounted for $260.8 billion in health spending - a decline of 0.8 percent and down from 2.9 percent growth in 2011.  The drop in projected spending was caused by declines in the average price paid for prescriptions (because a number of popular brand-name drugs lost patent protection and there was increased use of generic drugs), increases in cost sharing requirements, and lower spending on new medicines.  These factors were partly offset by more rapid growth in the number of dispensed prescriptions. estimated to have grown 1.3 percent in 2012, compared to 0.6 percent in 2011. 

In 2014 prescription drug spending growth is projected to accelerate to 5.2 percent, driven by increases in the use of prescription drugs by people who are newly insured and those who move to more generous insurance plans.  Additionally, drug spending growth is expected to rebound from the very low growth anticipated in 2012 and 2013 as the economy improves and the impact of patent expirations continues to diminish.  Through 2022... the proportion of generic drugs dispensed is anticipated to level off at roughly 85 percent, pushing average prescription drug prices up."
The projections reflect a combination of factors affecting health care spending, including provisions of the Affordable Care Act (ACA) that increase health insurance coverage and forecasted changes in the nation's economy."

In the dozen years between 2001 and 2012, at least 38 states had passed some type of state pharmaceutical assistance law and four others had executive agency initiatives, for a total of 42 states with assistance programs enacted or authorized.However, the number of operating programs is on the decline, due to  Medicare Part D benefits and expanded discounts available under the Affordable Care Act, starting in 2011.  Most use state funds to help pay for a portion of the cost of pharmaceuticals for eligible residents who meet age and income criteria. Some states also have established cost-sharing features including co-payments, annual enrollment fees, or monthly limits.

Other states are operating or authorizing broader discount programs aimed at assisting people lacking private insurance, or even the general consuming public. In separate actions, all 50 states have adjusted Medicaid pharmaceutical policy in the past decade. NCSL now has more than 40 reports and presentations on pharmaceuticals, most of which are online and summarized below.



PRESCRIPTION DRUG STATE LEGISLATION - Each year between 1999 and 2009 NCSL compiled and published the most comprehensive tracking report of bills and resolutions affecting pharmaceuticals.  The reports are updated including final outcomes at the end of each calendar and session year. These annual reports are offline, but are available upon request.  Reports for 2010-2014 are not available in published form.


These web documents include information on laws and initiatives to provide state subsidies, as well as discounts, bulk purchasing, price regulation and other regulatory and funding policies, including state Medicaid and Medicare activities:

NCSL session on Pharmaceuticals:
held Wednesday, July 23, 2008

 Hear about three programs that are up and running in a growing number of states.

  1. Prescription Drug Monitoring Programs help medical professionals prevent misuse and abusers from obtaining prescriptions fraudulently before the police knock on the door.
    > Speaker: Sherry Green, National Alliance for Model State Drug Laws, Alexandria, VA. - [ Handout#1 | Handout #2]
    > Alan Must, Purdue-Pharma, New Jersey - [ Presentation]
  2. The federal 340B Drug Pricing Program helps over 13,000 qualified health centers, clinics and hospitals provide comprehensive pharmacy services for over 10 million patients.
    > Speaker: Lisa Scholz, HRSA Pharmacy Services Support Center, Washington, DC. - [ Presentation]
  3. Medication Therapy Management (MTM) programs allow pharmacists to provide in-depth counseling to insure that patients get the full benefit of chronic prescribed drugs.
    > Edward Staffa, RPh, Vice President, Mirixa & NCPA spokesperson.
    > Marjorie Powell, Senior Assistant General Counsel, PhRMA, Washington, DC.

Non-NCSL Resources:   

Prescription Drug Resources for 2014 - A selection of additional reports from government, academic, industry and consumer sources, including 50+ direct web links, updated regularly.

Note on Resources:  NCSL provides links to other Web sites for information purposes only.  Providing these links does not indicate NCSL's support or endorsement of the site.


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