HI SB2933

Establishes a Prescription Drug Affordability Board within the Department of Health, consisting of five governor-appointed voting members with expertise in health economics, clinical practice, insurance, public health, or consumer advocacy, plus three ex officio non-voting members from state agencies.

Authorizes the board to conduct affordability reviews of drugs costing $30,000+ annually, those with price increases exceeding 15% in one year or 40% over three years, and generic drugs with 200%+ price increases in 12 months.

Empowers the board to set upper payment limits on drugs deemed unaffordable, based on Medicare Part D negotiated prices or Medicare maximum fair prices, applicable uniformly across all state-regulated payers.

Caps out-of-pocket costs for certain medications and prohibits copayment adjustment programs that prevent manufacturer or nonprofit financial assistance from counting toward patient deductibles and maximum out-of-pocket amounts.

Includes patient access protections with exemptions for rare disease treatments without alternatives, drugs that would be withdrawn from the state market, and hospital-only administered medications, with a waiver process for affected parties.