Colorado Prescription Drug Affordability Review Board and Advisory Council now accepting applications

Senate Bill 21-175, a bill passed by the Colorado Legislature and signed into law by Governor Jared Polis earlier this year, established the Prescription Drug Affordability Review Board and the Prescription Drug Affordability Advisory Council. Both bodies will be housed in the Colorado Division of Insurance, part of the Department of Regulatory Agencies (DORA). The goal of the Review Board and the Advisory Council is to save Coloradans money on prescription drugs and bring transparency to high drug costs in our state.

Applications for both groups are currently open and the Division encourages anyone with the necessary background, experience, and interest to apply.

Prescription Drug Affordability Review Board

The Prescription Drug Affordability Review Board will have the authority to review prescription drug costs and evaluate their impact on Coloradans through the following responsibilities and activities.

  • Collect and evaluate data on prescription drug costs to identify drugs that may be subject to an affordability review.
  • Perform affordability reviews if certain drug cost triggers occur – including high wholesale costs and significant cost increases across various categories. The Board then determines whether a prescription drug is unaffordable for Colorado consumers by analyzing multiple factors.
  • If a drug is found to be unaffordable, the Board may set an upper payment limit (UPL). However, the Board will not be able to set prices – the UPL simply caps the amount in-state purchasers may pay for a drug.
  • Make policy recommendations to the Colorado Legislature.
  • The Board will meet every six weeks starting in November 2021.

Applications for the Prescription Drug Affordability Board are currently open. Applicants are encouraged to apply no later than August 15, 2021.

Applicant Requirements

  • An advanced degree and experience or expertise in health care economics or clinical medicine
  • Must not be an employee, board member, or consultant of: a manufacturer or a trade association of manufacturers; a carrier or a trade association of carriers; or a pharmacy benefit manager or a trade association of pharmacy benefit managers
  • In addition, applicants must disclose any possible conflicts of interest.

Apply for the Prescription Drug Affordability Board

Prescription Drug Affordability Advisory Council

To ensure its work is transparent and informed by a variety of stakeholders, the Board will also appoint a Prescription Drug Affordability Advisory Council to provide input. The Advisory Council will consist of 15 members with varied experience in health care and will meet every three months.

The Board will look to appoint members who have experience serving underserved communities and who reflect the state’s diversity in terms of race, immigration status, income, disability, age, gender identity, and geography. In addition, the make-up of the council will include the following categories.

  • Two members who are health-care consumers or who represent health-care consumers
  • One member representing a statewide health care consumer advocacy organization
  • One member representing health care consumers who are living with chronic diseases
  • One member representing a labor union
  • One member representing employers
  • One member representing health insurance carriers
  • One member representing pharmacy benefit management firms
  • One member representing health care professionals with prescribing authority
  • One member who is employed by an organization that performs research concerning prescription drugs, including research concerning pricing information
  • One member representing manufacturers of brand name drugs
  • One member representing manufacturers of generic drugs
  • One member representing pharmacists
  • One member representing wholesalers

The 15th member must be the Executive Director of the Department of Health Care Policy & Financing or their designee.

In regards to geographic diversity, the Board will look to appoint at least one Council member from the Eastern Plains and one member from the Western Slope. Additionally, the Board will work to appoint members from each Congressional district in the state.

Applications for the Prescription Drug Affordability Advisory Council are currently open, and applicants to the Advisory Council are encouraged to apply no later than October 1, 2021.

Applicant Requirements – Council members must have knowledge of at least one of the following subject matters.

  • The pharmaceutical business model
  • Supply chain business models
  • The practice of medicine or clinical training
  • Health care consumer or patient perspectives
  • Health care cost trends and drivers
  • Clinical and health services research
  • The state’s health care marketplace

Apply for the Prescription Drug Affordability Advisory Council

Find more information at the Division of Insurance website for the Colorado Prescription Drug Affordability Review Board & Advisory Council.

This press release was provided by the Colorado Division of Insurance.