Gov. Abigail Spanberger on Tuesday vetoed legislation that would have created a state board to review prescription drug costs, saying that evidence from other states shows that such boards do not achieve the goal of lower prices.
“They are expensive undertakings that other states have either repealed or are considering repealing due to costs and ineffectiveness,” Spanberger said in a statement.
“I’m disappointed,” state Sen. Creigh Deeds, a Democrat from Charlottesville who patroned the Senate bill, said in a text message Tuesday.
Spanberger’s veto comes after amendments that she made to the bill were removed and the legislation was sent back to her without them during the General Assembly’s April 22 reconvene session. Those amendments, lawmakers argued, fundamentally changed the legislation.
As initially written, the legislation would have created a state-run prescription drug affordability board that would review the pricing of high-cost prescription drugs and, in some cases, set upper payment limits. It was passed by the General Assembly with wide bipartisan support.
Maryland established the first PDAB in 2019. Since then, 11 states have followed.
The 2026 effort was the fifth attempt to create such a board. Spanberger’s Republican predecessor, former Gov. Glenn Youngkin, vetoed similar legislation in 2024 and 2025.
Spanberger said her amendments would have changed the board to a panel to “study a reference-based pricing system before the state spends millions of dollars on implementation.”
She added that her amendments would have required greater drug pricing transparency and provided new data to give insight into out-of-pocket costs in Virginia. She also said her amendments would have expanded the attorney general’s investigatory and enforcement authority to “crack down on anticompetitive behavior between pharmaceutical manufacturers and insurance carriers.”
Deeds had previously said that the governor’s amendments made the legislation unpalatable. He had pointed out in April, when the governor amended the bill, that New Hampshire had adopted and repealed a similar effort to what the Virginia bill had become, because the legislation was “totally ineffective.”
“I am disappointed and frustrated by the veto but remain committed to fighting to lower prescription drug prices for Virginians and plan to reintroduce the legislation again in 2027 after work during the interim,” Del. Karrie Delaney, a Democrat from Fairfax County who patroned the House of Delegates bill, said in an email Tuesday.
Freedom Virginia, a left-leaning lobbying group, said in a statement Tuesday that Spanberger “sold out to ‘Big Pharma’ and abandoned hard working Virginians.”
“Spanberger said it herself in Congress and again on the campaign trail, Virginians are spending far too much money on prescription drugs, and pharmaceutical companies keep raising prices even faster than inflation,” said Rhena Hicks, co-executive director of Freedom Virginia.
“In 2022 after voting for the Inflation Reduction Act, she said she was proud of her vote to finally give Medicare the ability to negotiate with drug companies to lower costs and claimed that it wouldn’t just save seniors money but would save everyone money on their health care costs. Since then, she has known the financial challenges Virginians face at home and at the pharmacy counter and said time and time again how she would prioritize making medicine more affordable for her constituents if elected as governor.
“It’s beyond disappointing that now as governor she has chosen to flip flop and veto legislation that would have extended those same lower prices she was proud to vote for to even more Virginians,” Hicks added.
AARP Virginia has worked with advocates of the legislation for several years and said in a statement from the state director that the recent veto is “troubling because the Affordable Medicine Act passed with overwhelming support.”
The organization, which supports individuals aged 50 and up, has about 1 million members in Virginia.
“It is deeply disappointing that Virginians struggling to afford their prescription drugs will have to wait even longer for relief because of Gov. Spanberger’s veto of the Affordable Medicine Act,” the organization said. “This legislation would have extended Medicare-negotiated drug discounts to Virginians who are not enrolled in Medicare, savings that Virginia families urgently need.
“The veto is baffling, given Gov. Spanberger’s past support for the Inflation Reduction Act — the legality of which was affirmed by the Supreme Court just this week — which allows Medicare to negotiate lower prices for high-cost prescription drugs. By signing the Affordable Medicine Act, she had a clear opportunity to deliver similar relief to Virginians outside Medicare and to hold Big Pharma accountable.”
Critics of these boards say that they target the wrong player. Price caps focus primarily on the drug manufacturers and the prices they set for medications. With a PDAB in place, states only have control over the list price, which is what in-state purchasers pay for the drug, said Harry Gewanter, a pediatric rheumatologist in Richmond who has spoken to legislators about PDABs during the General Assembly.
When the list price is capped on a state-by-state basis, it doesn’t change the manufacturer’s list price. The capped price could fall below what the manufacturer considers financially worthwhile, and it could decide to stop distributing the drug in the state or limit how much is sent to the state. This could cause shortages of the medication.
Gewanter used the analogy that chicken farmers can sell eggs for whatever price they choose, while the supermarket ultimately decides how much consumers will pay. Pharmacy benefit managers, third-party companies that negotiate prices and manage prescription benefits for insurers, play a major role in determining reimbursement rates and how much a consumer will pay.
He said federal action is needed to reform PBMs.
Drug manufacturers have pushed back on some states that voted to establish an upper payment limit. Next January, Colorado is set to cap prices for the rheumatoid arthritis drug Enbrel, a process that took about four years. However, manufacturers have sued over the move, according to reporting from the Colorado Sun. The lawsuit is ongoing.
Del. Otto Wachsmann Jr., R-Sussex County and a pharmacist, opposed Virginia’s legislation, saying that these boards are not effective tools for controlling prescription drug costs.
“I really like the concept, but this isn’t going to work,” Wachsmann said during an interview Tuesday, adding that there could be damaging consequences.
Pharmacies purchase medications at wholesale prices and are later reimbursed at lower rates by insurers. This has caused many pharmacies to close throughout Virginia. Wachsmann said that three of the counties in his district don’t have a single pharmacy.
The pricing formulas for those drugs are not publicly disclosed, making the system difficult to fully track or understand.
Pharmaceutical Research and Manufacturers of America, also known as PhRMA, supported Spanberger’s decision.
“Her action reflects an understanding of the complexity of the pharmaceutical supply chain and the real risks of advancing a state-level approach rooted in federal price-setting policies in Medicare that have already raised significant concerns,” Will May, senior director of the organization, said in a statement.
“The Governor offered thoughtful, substantive recommendations, and after the General Assembly failed to heed them, her veto was the right step to protect Virginia patients from a flawed policy that may do little to lower what they actually pay at the pharmacy counter.
“Real affordability requires addressing the entities that actually determine what patients pay — insurers and pharmacy benefit managers that control access, set cost sharing, and decide whether rebates and discounts reach patients.”
