Colorado PDAB engaged in early stages of rule development process

Colorado’s Prescription Drug Affordability Board (PDAB) concluded its most recent meeting on June 3rd where the Division of Insurance Board staff outlined the Draft Proposed Rules for the drug cost review process.

 

 

Established under Senate Bill 175 in 2021, PDAB was established to conduct annual reviews of prescription drug costs through multi-stakeholder engagement with the aim of setting upper payment limits on essential drugs.

The draft rules proposed so far cover General Provisions and procedures and requirements for Use of Savings reporting, where carriers issuing health benefit plans would calculate savings attributable to the establishment of those limits.

The board is engaged in developing the draft rules for 3 separate frameworks of its drug assessment procedures:

  •         Use of savings reporting
  •         Affordability review
  •         Establishment of upper payment limits

The frameworks will proceed along their own individual timelines in the rulemaking process that will be coordinated and run through November of this year.

PDAB members heard from other state agencies involved in prescription drug affordability efforts in Oregon, Massachusetts, and Maryland during the final session of a learning series.

Members also considered the Department of Health Care Policy and Financing’s (HCPF) Canadian drug importation program to guide its considerations.

Lila Cummings, who serves under the board as Director of Price Drug Affordability, said PDAB will be holding a series of important stakeholder meetings in the coming weeks and months that will shape the outcomes of how the board conducts and establishes its policy review and recommendations.

 

“There’s going to be a lot of content that the board will be reviewing that we want stakeholder feedback,” said Cummings. “There [are] meetings coming up where we do want engagement and the board has said we want to hear from folks. If a stakeholder with a very specific perspective has a question and they say, ‘How would you implement this?’ or ‘What exactly does this mean?’, the board has said they want to hear from stakeholders, from advisory council members, they want to hear those questions.”

 

The 15-member Advisory Council, which includes HCPF Executive Director Kim Bimestefer and leaders from health care, pharmacy, and consumer interest groups, will review the draft rules in coming months and advise modifications.

Prescription Drug Affordability staff will hold its next meeting with stakeholders on June 22nd to review the drafts and gain feedback.