Drugs don’t work if people can’t afford them.

New Report: Illinois Could Save $190+ Million on Prescription Drugs

A new analysis from the Coalition for Prescription Drug Affordability finds that establishing a Prescription Drug Affordability Board (PDAB) through SB 3496 could save Illinois more than $190 million by automatically adopting Medicare-negotiated drug prices as statewide Upper Payment Limits. The report shows how a PDAB would deliver recurring savings for taxpayers, lower out-of-pocket costs for consumers, and reduce premium growth for employers and families—while maintaining access to life-saving medications. With drug prices continuing to rise and hundreds of thousands of Illinoisans at risk of losing coverage, the PDAB offers a proven, commonsense solution to make prescription drugs more affordable statewide.

Key Findings

Illinois could save over $192 million every year on prescription drugs by establishing a Prescription Drug Affordability Board (PDAB) — based on just the first 10 Medicare-negotiated drugs.
These savings are a conservative minimum. They do not include private insurance savings, future Medicare-negotiated drugs, or additional high-cost medications a PDAB could regulate.
A PDAB would extend Medicare-negotiated prices to all Illinoisans by adopting them as statewide Upper Payment Limits, lowering costs for taxpayers, consumers, and employers.
Prescription drug costs are a growing crisis. 77% of Illinois voters worry about affording medications, while rising prices drive higher premiums and out-of-pocket costs.
PDABs work. Colorado’s PDAB set its first Upper Payment Limit in 2025, with one drug projected to save up to $32 million annually.

VIEW THE EXECUTIVE SUMMARY

VIEW THE FULL REPORT

What is a Prescription Drug Affordability Board?

A Prescription Drug Affordability Board (PDAB) is independent body with the authority to evaluate high-cost prescription drugs and set reasonable rates for Illinoisans to pay.

The Board will review prescription drugs with costs that impact Illinoisans, including high-cost, brand-name medications. The Board will consider a broad range of economic factors when setting appropriate payment rates for reviewed drugs, allowing pharmaceutical manufacturers the opportunity to justify existing drug costs. Once a fair payment rate is determined, the Board sets an upper payment limit that applies to the entire supply chain.

Why Do We Need a PDAB?

Illinoisans are going without essential medication — or rationing it — due to high cost.

According to a 2024 Survey, 31% of Illinois adults reported they have skipped refilling a prescription or not filled one at all due to the cost. No one should have to choose between their medication and other necessities, like rent and groceries.

We pay more for the same medication that’s available in other countries for a fraction of the cost.

Other countries have rate-setting and negotiation mechanisms in place. Without that in the US, pharmaceutical manufacturers charge whatever they deem the market can bear. As a result, Americans have the highest spending per capita on prescription drugs among high-income countries. Here is a comparison of drug costs for several popular name brand drugs in Canada and the United States.

Drug spending contributes to 1/3 of health insurance premium costs.

High drug costs affect everyone, including people who aren’t on a prescription medication. CareFirst Blue Cross Blue Shield has reported that drug costs were the single largest contributor to overall spending in 2017, accounting for over 33% of total spending. Even when the out-of-pocket costs are manageable, the high cost of prescription drugs burden the entire healthcare system.

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Hear from Illinoisans: Drugs Don’t Work If People Can’t Afford Them

“This is important to me because as a person who takes a variety of medicine to keep my body functioning. I have experienced first-hand how expensive and inaccessible healthcare is in this country. I should never have had to stop a drug cold turkey due to it being too expensive, but I have had that happen to me multiple times since being unemployed”
Aria from Evanston
“I believe that a country with the resources we have in America must not shortchange its citizens when it comes to healthcare. No one should go without their medication because of its cost.”
Esther from Frankfort
“I work for a community clinic with employer-sponsored health insurance, and the deductible is too high for me to get needed outpatient treatments. The older I get, the harder it is to deal with medical conditions I can't afford to treat.”
Bonnie from Downers Grove
I'm a born disabled and chronically ill person who has constantly battled with health care costs her entire life. I was recently diagnosed with a condition where the on-label medication was not covered by my insurance and was $2500 out of pocket. We ended up ordering it from a Canadian pharmacy for under $200. My doctor and his nurse said that they ALWAYS have to refer their patients to Canadian pharmacies for this condition, meaning that this isn't an isolated incident.
Terri from Chicago
“As a Registered Nurse, I've seen too many patients unable to buy the meds needed to manage serious chronic conditions. It's not just painfully sad to witness this but also this causes more money needed as a person's condition worsens.”
Deborah from Roselle
“For most of my years in clinical medical practice, the majority of my patients were those with limited financial resources. In trying to persuade a patient to buy medications to treat chronic diseases I would say ‘I have no magic to cure you but medicines are as close as I can get.’ I knew from experience that the cost of appropriate, even generic meds, often prevented my patients from accessing the ‘magic’ they needed.”
Geralyn from Chicago
Affordable prescription drugs save lives. Given the high cost of many prescriptions, some people cannot afford them as a result do not take medication necessary to maintain their physical and mental health. No one should have to choose between eating and taking required medications.
Julie from Urbana
I take a medication that has become nearly impossible to procure in the last 12 months. The affordability and accessibility of medication is a huge issue.
Caroline from Morton Grove
“I take several different types of life-saving medication for my rare neuromuscular condition. I have more often than not had to ration my medication due to high costs. My partner also has experienced these since he has ADHD and his current medication cost is huge despite insurance. I am passionate about getting this fixed.
Iliana from Chicago
“The first time I went to pick up a psychiatric medication for my son, the cost was over $500. How many people could afford this without help?”
Lorri from Arlington Heights
"I started to ask the patients I cared for about their ability to afford the medications I was prescribing them. The responses were devastating. People were enduring debilitating pain, failing to fill life-sustaining medications, and using pill splitters to ensure they had enough medication until they could afford refills. Story after story of people choosing rent, utilities, school supplies, child care, and car notes over the price of medications that were critical to their health.”
Dr. Douglas from Chicago

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Hear from Illinoisans: PDAB in the Papers

"Illinois has a proud tradition of being a leader in addressing healthcare affordability. Creating a Prescription Drug Affordability Board would once again showcase our commitment to the well-being of the residents of our state. I urge our legislators to take decisive action in establishing this board. I hope others in our community will do the same."

-Jim McGrath, Barrington
Read the full letter to the editor in the Daily Herald here.
"Nearly one in four older adults report that affording their prescriptions is difficult, and this is even more likely among those with poorer health and lower incomes. High drug prices perpetuate health disparities. Limiting drug prices is an achievable way to eliminate this preventable suffering."

Dr. Julie Laut and Dr. Samantha Auerbach
Read the full letter to the editor in the News Gazette here.
"I care for the rich, poor and everyone in between. I cannot effectively care for patients if they cannot afford the therapies necessary to keep them well. Drugs don’t work if people can’t afford them. A prescription drug affordability board is the first step to making medications accessible and affordable for all.."

Dr. Anthony Douglas, Chicago
Read the full op-ed in the Chicago Sun-Times here.
"As a minority woman-owned and -operated small business based in Chicago, I have been personally impacted by the high cost of prescription drugs, and so have my employees, for whom we provide health insurance. When drug costs go down, so will insurance premiums, making it more sustainable for employers to provide quality health coverage. The benefits a PDAB offers to both employers and employees are clear."

- Andrea Raila, Raila & Associates, Chicago
Read the full op-ed in Crain’s Chicago Business here.
"In the richest country in the world, no one should be going without access to the medication they need due to cost. The issue also affects more than just those on regular prescription medications. Prescription drugs are increasingly contributing to higher health insurance premium costs and currently make up 33% of our premiums."

Jerry Freda, Inverness
Read the full letter to the editor in the Daily Herald here.
"As a medical professional, there is only so much that I can do to help my patients if the treatment I recommend is too expensive for them to afford. But this session, Illinois legislators have the opportunity to take action on rising drug costs by establishing a Prescription Drug Affordability Board (PDAB). "

Dr. Shazia Khan, South Barrington
Read the full letter to the editor in the Daily Herald here.
"Everyday people with disabilities with underlying diagnosis such as the above mentioned are faced with the daily decision to either purchase the prescription, paying their rent, and/or buying groceries. High-cost drugs account for nearly one- third of all insurance premiums. As the cost of prescription drugs continues to grow, insurance companies will keep raising premiums on our diverse communities to compensate for the cost."

Hershel Jackson-Rock Island
llinois-Iowa Center for Independent Living
Read the full letter in the Quad City Times here.
"My family is directly affected by the lack of prescription drug policies. Record profits go to 'Big Pharma' based not on merit but contractual obligations. This just isn’t sustainable, and it isn’t fair to the people of Illinois."

-Josef Michael Carr, Chicago
Read the full letter to the editor in the Chicago Sun-Times here.
"Years ago, if I prescribed medications that had been around for many years, it was likely that my patients could afford them. For the last 10 to 15 years I practiced, that assumption was no longer true. In 2022, over 1,400 medications increased in cost, a higher percentage than the rate of inflation."

-Dr. Geralynn M Kahn, North Center
Read the full letter to the editor in the Chicago Sun-Times here.
“Worry about medication affordability isn’t contained to party lines. Across the board, no matter the party affiliation, Illinoisans support bringing costs for medications down for everyone...Illinois legislators must continue the fight for health care affordability and resist the Big Pharma opposition to making health care accessible for everyone."

-Krystle Able, executive director, Illinois Alliance for Retired Americans, Chicago
Read the full letter to the editor in the Chicago Tribune here.
"There are already plenty of miracle cures for life-threatening conditions on the market, but what good are they if people can’t afford them? That’s why I support the Prescription Drug Affordability Board (PDAB) being considered by Illinois lawmakers. It would be a shield against Big Pharma's unchecked greed."

-Judy Janes, Palatine
Read the full letter to the editor in the Daily Herald here.
"My husband and I often struggle to access our critical medications due to these extremely fluctuating prescription drug costs. I have been taking medication for my chronic autoimmune disorder, myasthenia gravis, since I was 13 years old, and I have seen firsthand how frequently the prices of my critical, life-altering medications can change. It is a gut-wrenching issue to have to deal with."

-Iliana Rivera Haven, Chicago
Read the full letter to the editor in the Chicago Tribune here.

FREQUENTLY ASKED QUESTIONS:

A PDAB is an independent body that reviews affordability challenges for Illinois consumers and has the ability to set upper payment limits on prescriptions. The board holds the pharmaceutical industry accountable for the prices it sets so Illinois residents can afford their life-saving medications.
A broad-based nonpartisan coalition of nurses, doctors, public health advocates, and more are urging lawmakers to create a PDAB to lower the cost of prescription drugs and be a voice for consumers.
The PDAB would be made up of nonpartisan leaders in healthcare economics, health policy, and clinical medicine with no personal or financial stake in the pharmaceutical industry appointed by the governor.
Their sole purpose is to check the pharmaceutical industry's power by making prescription drugs more affordable and will use a data-based approach to set limits on the most expensive drugs.
It will be a public board with complete transparency and will comply with the Open Meetings Act.
The pharmaceutical industry opposes any regulation that could affect their profits – and patients pay the price. That’s why small business owners, faith leaders, healthcare professionals, public health advocates, and patients demanding accountability are urging lawmakers to do more to rein in the high cost of prescription drugs in Illinois.
Colorado, Maine, Maryland, Minnesota, New Hampshire, Washington, Oregon and Ohio
Michigan, New Jersey, New Mexico, Virginia, and Pennsylvania are working to create similar boards as well.
That would be up to the independent board to decide using a data-based approach to set limits on the most expensive drugs for Illinois consumers.
The types of drugs that will likely be considered might include drugs for cancer, autoimmune diseases, and diabetes.
You can make your voice heard by contacting your state legislators and urging them to support the Prescription Drug Affordability Act. Let them know why this issue is important to you and why you believe everyone in Illinois deserves access to affordable medicine.
A PDAB would benefit all Illinoisans. Illinoisans on expensive medication could see reductions in their out-of-pocket costs if their medication is selected to have an Upper Payment Limit. Additionally, high drug costs affect everyone, including people who aren’t on a prescription medication, because prescription drug spending contributes to 1/3 of health insurance premium costs.