Overview

• The Colorado Prescription Drug Affordability Board voted on Oct. 3 to impose an upper payment limit that applies to insurers and patients statewide.
• The $600 ceiling translates to about $31,200 per year for typical adult weekly dosing and roughly $15,600 for many children with juvenile arthritis.
• Federal officials calculated a Medicare maximum fair price of about $584 for Enbrel, which the state cited in selecting its $600 figure.
• Amgen called the move unlawful and warned of new access barriers, and additional legal challenges are expected after Judge Nina Wang dismissed the company’s earlier suit in March for lack of proven harm.
• Patient advocates praised the potential relief, while PhRMA and independent pharmacies warned of reimbursement strain and possible disruptions in access.