NGA Releases Strategies for States on Pharmaceuticals

Addressing public health crises by improving access to pharmaceutical interventions while ensuring fiscal sustainability

WASHINGTON — Today the National Governors Association Center for Best Practices (NGA Center) released Public Health Crises and Pharmaceutical Interventions: Improving Access While Ensuring Fiscal Sustainability, which summarizes potential state strategies to address public health crises by improving access to evidence-based pharmaceutical interventions while ensuring fiscal sustainability of public programs. The potential strategies were vetted by 11 states: California, Delaware, Louisiana, Massachusetts, New Mexico, New York, Ohio, Oregon, Rhode Island, Virginia and Washington.

The NGA Center supported the participating states in generating ideas on how they can balance access and cost concerns related to pharmaceutical interventions that help address public health crises, such as opioid use disorder and Hepatitis C. The project also brought together key stakeholders such as manufacturers, payers, consumers and others to provide input on potential strategies. The ultimate goal was to determine what approaches may be of interest to states.

“Addressing public health crises is a critical issue for governors and states,” said NGA Executive Director Scott D. Pattison. “Pharmaceutical interventions are often an important part of addressing those crises but can sometimes present fiscal challenges for states with already difficult budget scenarios. This paper provides an array of options that could help states strike the right balance. An important piece of this will be establishing effective partnerships with the federal government, manufacturers and others.”

The 11 states identified strategies focused on enhancing purchasing power, utilizing alternative payment mechanisms, fostering transparency and conducting value assessments, among others. The paper summarizes key considerations for states that may want to pursue these strategies, as well as the perspectives of various stakeholders.

“The Hepatitis C burden is growing in conjunction with the opioid crisis, and while the price of new treatments has come down, the cost is still far too high to treat all those who need it in our state.” Louisiana Governor John Bel Edwards said. “I am encouraged by and interested in pursuing several of the strategies identified through NGA’s work – particularly those that involve new financing approaches that can help us get our residents the care they deserve as quickly as possible.”

Massachusetts Governor Charlie Baker, whose state participated in the project said, “Finding ways to address the cost of pharmaceutical interventions is critical to our ability to effectively manage our public programs and provide access to medications.” He added, “States need more options to manage these costs and make informed decisions about what we are paying for.”

For more information on the NGA Center Health Division, click here.

About NGA

Founded in 1908, the National Governors Association (NGA) is the collective voice of the nation’s governors and one of Washington, D.C.’s most respected public policy organizations. Its members are the governors of the 55 states, territories and commonwealths. NGA provides governors and their senior staff members with services that range from representing states on Capitol Hill and before the Administration on key federal issues to developing and implementing innovative solutions to public policy challenges through the NGA Center for Best Practices. For more information, visit