Patient advocacy and healthcare provider organizations have sent a letter to Virginia’s Governor-Elect Spanberger urging caution on proposed Prescription Drug Affordability Board (PDAB) legislation. Despite operating for years in multiple states, PDABs have failed to save patients or states any money while creating potential access barriers—New Hampshire even repealed its PDAB in 2025 due to cost concerns. The coalition argues that focusing only on manufacturer pricing ignores the complex supply chain involving PBMs, insurers, and pharmacies, and recommends Virginia study proven solutions like insurance benefit design reforms and ensuring PBM rebates flow to patients before implementing an untested approach.