By Charlie Kolean
Friday, 29 May 2026 04:16 PM EDT
Nationally, states are grappling with how to address the soaring costs of healthcare and prescription drugs. Texas lawmakers currently examining healthcare affordability have a critical opportunity to get this right.
The focus must be placed squarely where the highest costs originate: the drug manufacturers themselves.
Texas has a chance to rein in Big Pharma’s unchecked pricing power and lower costs for Texans without jeopardizing the pharmacy access that our rural, veteran, and minority communities rely on.
If Texas is serious about healthcare affordability, it must look at mechanisms that actually lower the list price of medications set by massive pharmaceutical corporations.
Texas is already a leader in transparency.
In 2019, the state passed House Bill 2536, considered one of the nation’s most aggressive drug price transparency measures.
This law created the Texas Prescription Drug Price Disclosure Program, which forces drug manufacturers to disclose and justify when a drug’s price increases by 15% in a single year or 40% over three years.
But transparency is only the first step. To achieve real affordability, Texas can expand its efforts by looking at proven mechanisms that directly target high drug costs, such as Prescription Drug Affordability Boards (PDABs).
A PDAB is an independent, state-level entity empowered to evaluate the costs of the most expensive prescription drugs and determine if their prices are creating affordability challenges for the state healthcare system and its patients.
Crucially, strong PDABs have the authority to establish Upper Payment Limits (UPLs) — a cap on what state agencies, health plans, and patients can be charged for a specific drug.
• Currently, nine states have established PDABs.
• Four of those states (Colorado, Maryland, Minnesota, and Washington) have empowered their boards with the authority to set UPLs.
• Colorado recently made history by becoming the first state to set a UPL, capping the cost of the rheumatoid arthritis drug Enbrel at $600 per dose — saving patients and the state millions.
Even our neighbors in Louisiana are beginning to recognize the need for this scrutiny.
During their current legislative session, lawmakers passed SB 401, which created a PDAB within its Department of Insurance to review the costs of brand-name drugs and biologics.
The Texas House Select Committee on Health Care Affordability is conducting hearings this week that represent a pivotal moment for the state.
Texas can and should do better than Arkansas and Tennessee who recently passed misguided legislation that hurts pharmacy access and overall healthcare costs for patients and employers.
Lawmakers should not pass any legislation that hurts access and affordability of healthcare by forcing pharmacies to close.
Instead, they should build upon the transparency measures of HB 2536 and establish a robust Prescription Drug Affordability Board with the teeth to set Upper Payment Limits.
By holding pharmaceutical manufacturers accountable for the prices they set, Texas can lower costs for employers, save taxpayer dollars, and ensure that every Texan can afford the medications they need — at the local pharmacy they trust.
Charlie Kolean has worked as a senior policy adviser for state legislators, multinational corporations, and think tanks. Mr. Kolean has been involved in politics for over a decade as an activist, candidate, political consultant, and party leader. He was a bundler on the Trump Finance Victory Committee, and is a member of the American Association of Political Consultants.
