Colorado Prescription Drug Affordability Board Faces Some Resistance

A Prescription Drug Affordability Board (PDAB) that Colorado lawmakers created three years ago as a way to help control costs of particularly expensive drugs has encountered opposition from some users of such drugs who fear the PDAB’s actions could cause more harm than good. The PDAB is tasked with reviewing whether drugs are unaffordable and can set caps on what patients and insurers have to pay for them. As reported by The Colorado Sun news outlet, the potential problem that users of these specialized drugs fear is that manufacturers of the drugs might stop making them available in Colorado if their revenues are too adversely affected. It is apparently a valid concern. Manufacturers whose drugs might be targeted by the PDAB have taken steps to resist. When the Board began to consider placing a cap on the arthritis drug Enbrel, its manufacturer, Amgen, sued the state in an effort to strike down the PDAB’s authority. And The Sun also noted that when the PDAB considered whether to place a cap on the cystic fibrosis drug Trikafta, members of the cystic fibrosis community advocated not doing that. The manufacturer, Vertex, wrote in a letter to the PDAB that placing an upper limit on a drug’s price might force it and other drugmakers to withdraw from Colorado. “Ultimately, the PDAB decided not to declare Trikafta unaffordable,” stated The Sun, “citing Vertex’s patient-assistance programs. But the feeling of trauma lingered for patients.” A 2024 legislative bill, SB 24-203, seeks to address some of these concerns. It would require that certain measures be taken by the PDAB in determining whether to conduct an affordability review for an identified prescription drug. Specifically, it would require the Board to consider whether the drug has an approved orphan drug designation for one or more rare diseases and no other indications and, if so, to consider input from consumers and the Colorado rare disease advisory council. But, said The Sun, patients worry the bill may not provide enough protection.

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