As a physician for more than 40 years, my patients have been impacted by the cost of some prescription medications. Nearly one in three of our neighbors resort to splitting pills, skipping doses or not filling prescriptions for medically necessary medication due to cost. 

Pharmaceutical companies record historic profits and, since 2008, the median price of a new medication rose from around $2,100 per year to jaw-dropping amounts well over $100,000 per year. Yes, these medications are remarkable, they are used for specific conditions for which there are few if any other options, they change the trajectory of the illness, and a limited number of people need them so their cost cannot be diluted by volume sales. Too many Nevadans report being somewhat or very worried about the cost of prescription medications, and most support establishing a maximum fair price for expensive medications. 

Assembly Bill 250, the “Affordable Medicine Act,” has been sent to Gov. Joe Lombardo. The bill uses the rates negotiated by Medicare for Americans 65 and older, and applies them to all Nevadans regardless of age. This common-sense approach to pharmaceutical affordability can save Nevadans considerable money, starting in 2026, when the first 10 medications will be identified (with more added annually, thereafter). 

AB250 aims to rein-in prescription medication costs. It generates opposition arguments that pharmaceutical companies may reduce or stop their research and development programs, yet these same companies often spend considerable amounts annually on product advertising and/or stock buybacks. While innovative medications continue to be developed, many “new” medications are variations of existing ones with minor chemical changes allowing for long patent protection, and not requiring massive front-end investments.

Additionally, some opponents suggest that Nevadans may lose access to certain medications as a consequence of AB250’s passage. That form of antitrust behavior would then likely trigger state and federal investigations and litigation, so it would not be expected from any pharmaceutical company planning to remain in business for the long term. 

Claims that pharmacists will be forced to sell medications below their cost are due to misunderstanding of AB250. The bill requires that patients pay no more than the federal Medicare negotiated price at their point of service. A pharmacy “filling” fee is allowed to cover the pharmacist’s expenses, and the onus to deliver medications at the negotiated prices for Nevadans ultimately falls to pharmaceutical manufacturers, distributors and pharmacy benefits managers through rebates or whatever means they influence. Prices will be public information, with all patients, prescribers, facilities and pharmacists knowing the exact price. 

Our governor has the opportunity to help all Nevadans needing access to affordable medications, often for serious conditions. I urge Gov. Lombardo to sign AB250 as sent to his desk. 

Dr. Barry Cole is board-certified psychiatrist with more than 40-years' experience. A longtime resident of Las Vegas now living in Reno, he obtained his undergraduate degree in bacteriology at the University of California, Berkeley, his medical doctorate at the Wake Forest University School of Medicine, and his master’s degree in public administration from UNLV. He is a distinguished life fellow of the American Psychiatric Association and active in the Nevada Psychiatric Association. He registered as a nonpaid lobbyist for the 2023 Nevada Legislative session.