Letter to the Editor: Drug Affordability Board Could Block Access to Rare Disease Treatments

Editor’s note: This letter is in response to the opinion piece titled “Don’t Let Big Pharma Gut Colorado’s Prescription Drug Affordability Board,” published by the Colorado Times Recorder on February 20, which can be read here.

In her February 20 opinion, “Don’t Let Big Pharma Gut Colorado’s Prescription Drug Affordability Board”, Dr. Maria Chansky urges Colorado lawmakers to oppose Senate Bill 60, legislation that would exempt rare disease treatments from disastrous price controls that the Colorado Prescription Drug Affordability Board (PDAB) can enact. What Dr. Chansky failed to mention is that drug price control mechanisms, such as upper payment limits (UPLs), will put such treatments out of reach for the patients who need them.

SB 60 is critical to protecting treatment access for smaller patient populations and would codify advice from the Board’s own advisory committee that the Board failed to implement. UPLs, which set a maximum amount that a purchaser or payer can reimburse for a drug, can lead to lower reimbursement rates for pharmacies and providers who purchase and dispense medications. However, the implementation of UPLs on drugs does not require any savings be passed on to patients or returned to a plan sponsor. 

Patients with rare and chronic health conditions in Colorado and beyond have repeatedly raised concerns about how UPLs can increase access challenges. Yet the PDAB does not have any metrics in place to ensure such policies will actually lower costs for patients.

State lawmakers must support SB 60 – and additional protections that protect access to treatments and sustain the lives of individuals living with HIV and other complex conditions – to ensure patients are truly at the center of state efforts to improve affordability. 

Jen Laws is president and CEO of the Community Access National Network, a national nonprofit organization that works to improve access to healthcare services and supports for people living with HIV/AIDS or viral hepatitis in Colorado and across the country for the last 27 years.