Maryland Sets First Drug Price Cap on Diabetes Medication Jardiance at $204 Per Month
Key Insights
Maryland's Prescription Drug Affordability Board established the state's first upper payment limit for Jardiance, capping the diabetes medication at $204 for a 30-day supply by January 2027.
The price cap, set at $6.80 per pill, is benchmarked against Medicare's maximum fair price and adjusted for inflation, with an estimated annual savings of $320,000.
The decision makes Maryland only the second state to implement such pricing controls, following Colorado's action on Enbrel, and has triggered pushback from the pharmaceutical industry.
Maryland's Prescription Drug Affordability Board has established the state's first upper payment limit for a prescription medication, setting a price cap of $204 for a 30-day supply of the widely prescribed type 2 diabetes (search) treatment Jardiance. The decision marks only the second time a state panel has taken such action to control drug costs.
Price Cap Implementation and Savings
The board will oversee implementation of the new pricing structure by January 2027, when Jardiance will be capped at $6.80 per pill for state and local government health plans. According to Andrew York, the executive director of the Maryland board, the pricing was benchmarked against the maximum fair price paid by Medicare, with adjustments made for inflation to reach the 2027 target price.
The move is projected to generate annual savings of $320,000 for Maryland's state and local government health plans. The board, designed to function like a state utility commission, specifically targets costs for government-sponsored health coverage rather than private insurance plans.
Industry Pushback and Regulatory Precedent
The decision has sparked opposition from the pharmaceutical industry and other stakeholders who question the benefits for patients. Jardiance, manufactured by Eli Lilly and Boehringer Ingelheim, represents a blockbuster diabetes treatment that has become a target for state-level price control measures.
Maryland's action follows Colorado's precedent-setting move in 2025, when that state's Prescription Drug Affordability Board established an upper payment limit for the biologic medication Enbrel. Colorado's decision prompted immediate litigation from drugmaker Amgen, highlighting the controversial nature of state-level pricing authority.
Regulatory Framework and Authority
Only a select number of state Prescription Drug Affordability Boards possess the authority to set upper payment limits (UPLs), making these pricing interventions relatively rare but potentially significant for pharmaceutical cost management. The boards represent a state-level approach to drug pricing that operates independently of federal Medicare negotiation programs.
The Maryland board's decision specifically applies to what state and local government health plans pay for Jardiance, rather than affecting pricing across all insurance types or direct-pay patients. This targeted approach reflects the board's mandate to control costs for government-sponsored healthcare coverage while operating within existing regulatory frameworks.