VA SB271

Establishes a Prescription Drug Affordability Advisory Panel under the Secretary of Health and Human Resources with six members to analyze drug pricing trends, develop policy recommendations, and submit annual reports to the Governor and General Assembly starting December 31, 2026.

Requires the All-Payer Claims Database to report annually to the new Panel on prescription drugs with price increases of 10% or more or rebate decreases of 10% or more during the preceding calendar year.

Prohibits manufacturers and wholesale distributors from accepting payment above the federal maximum fair price for referenced drugs intended for use in Virginia, effective January 1, 2027.

Requires pharmacies to be reimbursed at least the maximum fair price or national acquisition cost (whichever is greater) plus dispensing fees for referenced drugs.

Imposes civil penalties of $10,000 per violation for entities that violate pricing provisions, and penalties of $100,000 or total annual savings (whichever is greater) for manufacturers who withdraw drugs from Virginia to avoid price limitations without providing 180 days' notice.