On October 3, despite hearing testimony from a variety of stakeholders (including CBSA) expressing significant concerns, the Colorado Prescription Drug Affordability Board (PDAB or Board) set its first Upper Payment Limit (UPL) for the autoimmune drug Enbrel. This makes Colorado the first state PDAB to take this “landmark” step toward implementing this ill-conceived mechanism to control drug costs.
The PDAB decided to utilize the Medicare Maximum Fair Price (MFP) of $583.59 as a benchmark and, after a fairly lengthy and confusing discussion of units/dosages/packaging, rounded up to $600.00 per 50 mg/mL, which will apply to all commercially available formulations of Enbrel and will be reviewed
annually.
The Board set the effective date for this UPL as January 1, 2027, instead of “at least six months after adoption date.”
Amy Goodman, CBSA’s Vice President and Counsel…
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