In recent years drug costs have grown far faster than other health care services, last year growing 8.1% compared to overall health spending growth of 4.8%. Forty five new drugs were approved in the US last year, up from 41 the year before and 27 in 2013. Those increases are straining government budgets, squeezing out resources for other priority areas. When asked about their top concerns affecting Medicaid spending, state officials most often cite pharmaceutical costs. As Congress has not been able to act to control costs, states are moving into the gap. Drug costs and prices are complex and much is hidden from view, which makes finding solutions difficult. While many states are considering drug price transparency legislation, this June Vermont became the first state to pass a law requiring drug companies to explain large price increases. In response to questions from state and provincial policymakers, CSG-ERC has published Vermont’s Drug Transparency Law: A Promising Work in Progress. The brief explores how Vermont’s law evolved, what it includes, how Vermont was able to pass legislation over the objections of a very strong lobby, where the process stands now, and what state leaders hope to accomplish with the information.