MD SB357

Expands the Prescription Drug Affordability Board's authority to set upper payment limits on prescription drugs that cause affordability challenges, initially for state/local government purchases and Medicaid, with potential expansion to all purchases statewide after two drugs have limits in effect for one year

Adds four new members to the Stakeholder Council: representatives of the rare disease community, oncologists, and patient advocacy organizations, increasing diversity of input on drug pricing decisions

Requires the Board to report annually on the effects of upper payment limits, including impacts on patient out-of-pocket costs, insurance premiums, pharmacy viability, 340B providers, specialty drug access, and the state biotechnology industry

Prohibits the Board from applying upper payment limits to drugs in current shortage, enforcing limits against Medicare Part C/D reimbursements, or counting pharmacy dispensing fees toward payment limits

Exempts federal programs (Veterans Affairs, TRICARE, Federal Employees Health Benefit Plan) and 340B Drug Pricing Program purchases from upper payment limits; requires Board consultation with Maryland Medicaid before setting limits affecting that program