PHARMACEUTICALS: Facts, Policies and NCSL Resources


AT A GLANCE:  Prescription drugs continue as one of the more active health policy issues in 2016-2018. NCSL has followed the state aspects of these issues for a number of years.

As reported in 2016, the United States spends more than $320 billion dollars on prescription medicines annually. Total spending on drug therapies is about $371 billion dollars, including over-the-counter (OTC) drug remedies, valued at 31 billion.

2018 Prescription Drug Legislation Database  - NCSL's state legislation online database tracks major policies affecting prescription drugs and biologic medicines. The features allows policymakers to view more than 3,500 filed bills across all 50 states and D.C., according to specific topics such as 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 free 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.

LATEST NCSL REPORT - February 23, 2018
A new report Prohibiting PBM “Gag Clauses” that Restrict Pharmacists from Disclosing Price Options - Recent State Legislation 2017-2018 is being released this week focusing on consumers being charged higher prices beacuse pharmacists are not allowed to offer options to patients with health insurance. The NCSL report is the basis of a New York Times, article printed and online Sunday 2/25/2018: Why Your Pharmacist Can’t Tell You That $20 Prescription Could Cost Only $8. Connect to the NCSL report.

In the dozen years between 2001 and 2012, at least 38 states had passed some type of state pharmaceutical assistance law.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.


NCSL In the News:

  • Absent federal action, states take lead on curbing drug costs. As Congress stalls on what many voters say is a top health concern — high pharmaceutical costs — a growing number of states are trying to tackle the issue themselves. Despite often-fierce industry opposition, Maryland, California, Nevada, New York and Vermont have passed legislation meant to undercut skyrocketing prices. “There is a noticeable uptick among state legislatures and state governments in terms of what kind of role states can play in addressing the cost of prescription drugs and access,” said Richard Cauchi, health program director at the [NCSL]. Washington Post, Oct. 2, 2017

  • Drug Price Transparency Laws-may-not-drive-down-spiraling-costs-for-consumers. NCSL cited, "Proposals in other states have included requiring pharmaceutical companies to report closely held research and development costs to government agencies, creating pharmaceutical review commissions and allowing government health programs not to cover certain high-priced drugs. Most of the measures have stalled this year, except in California, New Jersey and Pennsylvania, according to [NCSL]. Supporters of such legislation attribute their failure to proceed in most states to strong pressure from the pharmaceutical industry." KQED media.

  • "Angry Over Drug Prices, More States Push Bills for Pharma to Disclose Costs" - NCSL quoted, “While it is too soon to know if this prescription transparency legislation will continue to expand this year,” says Richard Cauchi, the program director for health insurance, financing and pharmaceuticals at the National Conference of State Legislatures, “state legislators often do look at what their colleagues in other states are doing.”  Wall Street Journal, April 24, 2015.



Biologics and Biosimiars state law map

Map of 2015-2016 prescription drug state enacted laws by NCSL

Resources from NCSL and expert speakers:


NCSL Prescription Drug session- November 2015
With pharmaceutical access and costs back in the headlines, NCSL collaborated with Pew Family Trusts to present a session for legislators on Nov. 4., 2015  The materials compiled are available now; they include

Session: "New Medicines: Opportunities and Challenges" - Seattle, August 2015


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:



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 2015-2017 - A selection of additional reports from government, academic, industry and consumer sources, including 50+ direct web links, updated regularly.

phoyo of pills

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.