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Office of Pharmaceutical Policy and Analysis

Overview

The Massachusetts Health Policy Commission’s (HPC) Office of Pharmaceutical Policy and Analysis (OPPA) was established in 2025, a component of historic legislation that also limited out-of-pocket costs for certain high-value drugs and expanded oversight of pharmaceutical companies and pharmacy benefit managers (PBMs). 

The main function of OPPA is to serve as the hub of expertise on pharmaceutical drug policy in Massachusetts by collecting and analyzing pharmaceutical data, conducting cutting-edge analyses related to access, affordability, and spending on pharmaceutical drugs in the Commonwealth, and developing recommendations on pivotal matters related to pharmaceutical policy. 

Key Focus Areas

OPPA is directed to conduct in-depth analyses and report annually on pharmaceutical spending trends in Massachusetts. The office is also tasked with surveying health plans annually and reporting on benefit design — covering topics such as tiering, cost-sharing, and utilization management. OPPA’s reports will help shape public discourse and inform state-level decision-making.  

OPPA also administers the HPC’s Drug Pricing Review Program, through which the HPC was granted the authority to support MassHealth, the Commonwealth’s Medicaid program, in its price negotiations with drug manufacturers.  

Rising Pharmaceutical Spending

Addressing rising pharmaceutical pricing, spending, and patient access issues are a top focus for the HPC and leading state policymakers. Since 2019, prescription drug spending has become one of the fastest areas of spending growth in the Commonwealth, and patients face rising out-of-pocket costs when accessing critical medications. 

bar graph of average annual growth in commercial spending per enrollee by site of care, 2019-2023
Notes: Pharmacy sending is net of rebates. Share of spending does not sum to 100% as sites of care with smaller spending amounts are not shown. Spending amounts in all hospital categories include both professional and facility spending. Sources: HPC analysis of Center for Health Information and Analysis (CHIA) Total Medical Expenditures, 2019-2023 (pharmacy spending, full claims only), HPC analysis of CHIA All-Payer Claims Database V2023, 2019-2023 (spending at other sites).

Read more of the HPC’s research on pharmaceutical drug trends.  

Strengthening Pharmaceutical Access and Affordability

Prescription drugs are an essential part of health care, yet for many Massachusetts residents, the rising cost of medications creates barriers to care. When prescription drugs become unaffordable, patients may delay filling prescriptions, skip doses, or forego treatment altogether -- decisions that can lead to worse health outcomes and higher overall health care costs in the long term.

Graphic of pharmaceutical bottle and magnifying glass next to text “1 in 10 Massachusetts families went without prescription drugs in 2023 due to costs.”
Source: CHIA 2023 MHIS

Through rigorous research and collaboration with stakeholders and experts, OPPA supports the development of sound, actionable policies. Its work prepares state leaders to:

  • Identify key cost drivers and implement targeted interventions to control pharmaceutical costs.
  • Improve affordability and equitable access to prescription drugs for Massachusetts residents.
  • Enhance pricing transparency and regulatory oversight of pharmaceutical manufacturers and pharmacy benefit managers (PBMs).

OPPA’s work supports the shared goal of a more transparent, affordable, and equitable health care system in Massachusetts.  

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Resources and Related Work