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DENVER, CO - The House today introduced two bills that will reduce the cost of prescription drugs.
HB23-1225, sponsored by Representatives Chris deGruy Kennedy and Ruby Dickson and Senator Sonya Jaquez Lewis, increases the effectiveness of the Prescription Drug Affordability Board (PDAB) to lower out-of-pocket prescription drug costs for Coloradans.
“Colorado Democrats have made substantial progress lowering the cost of prescription drugs and saving Coloradans money on their health care,” said Rep. Chris deGruy Kennedy, D-Lakewood. "Big pharmaceutical companies shouldn’t be able to rake in record profits as hardworking Coloradans struggle to afford the medications they need. With this legislation, we’re extending the effective cost saving measures established with the Prescription Drug Affordability Board to more drugs in order to save Coloradans money on their prescriptions."
“As a pharmacist I know firsthand how critical it is that Coloradans are able to afford their prescription drugs, but too many of our families are still getting squeezed by high costs of medication,” said Sen. Sonya Jaquez Lewis, D-Longmont. “The Prescription Drug Affordability Board is an essential tool to keep Colorado prescription drug prices affordable, and these changes will make the Board even more effective at saving families money on their life saving medications.”
“Every day, Coloradans across the state are having to choose between filling their life-saving prescriptions, buying groceries or paying rent,” said Rep. Ruby Dickson, D-Centennial. “This new legislation builds on our work to lower prescription drug costs by improving how the Prescription Drug Affordability Board will work. By limiting out-of-pocket costs for more life-saving drugs, this legislation will ensure that more Coloradans can access essential medications at a cost they can afford.”
In 2021, lawmakers passed the Prescription Drug Affordability Board to evaluate and place upper price limits on the highest cost prescription drugs. The legislation introduced today will increase the impact of the Prescription Drug Affordability Board to save people money on out of pocket prescription drug costs. It removes the limit on setting no more than 12 Upper Payment Limits (UPLs) per year in the first three years of the PDAB, and improves the criteria for selecting drugs for an affordability review.
“Pharmacy Benefit Managers can be a big part of our efforts to save Coloradans money on prescription drugs, but they have to follow the rules,” said Rep. Iman Jodeh, D-Aurora. “We’ve passed legislation to save consumers money on healthcare costs, but PBMs are coming in between consumers, health insurance plans, pharmacies and manufactures while making large profits. This bill will protect consumers and employers and save Coloradans money by making sure that PBMs follow the rules.”
“Our bill strengthens consumer protections and holds pharmacy benefit managers accountable to ensure that Coloradans save money on prescription drugs,” said Rep. David Ortiz, D-Littleton. “We’ve made incredible progress toward lowering the cost of prescription drugs. This legislation will allow the Commissioner of Insurance to investigate, hold hearings, issue cease-and-desist orders, and impose penalties on PBMs for failing to comply with cost saving measures and consumer protections.”
HB23-1227, sponsored by Representatives Iman Jodeh and David Ortiz and Senator Perry Will, will ensure that Pharmacy Benefit Managers follow through on critical cost savings reforms. The legislature has passed reforms to ensure that PBMs save consumers money, and this bill would ensure that PBMs follow through. This bill will provide the Division of Insurance with more direct oversight over PBMs by requiring them to register and specifying that that Division has the ability to enforce those reforms.
Specifically, this bill would allow the commissioner the power to investigate and impose penalties on PBMs for failing to comply with consumer protections such as charging pharmacies fees to adjudicate claims, clawing back money from pharmacies inappropriately, and discriminating against independent pharmacies versus PBM affiliated pharmacies.
Last week, the House also introduced HB23-1201, sponsored by Representative Lindsey Daugherty and Matt Soper. Currently PBMs can charge employers one price, but reimburse pharmacies less and keep the difference, a practice known as price spreading. This bill makes it an unfair business practice for PBMs to charge employers more for a drug than what they pay pharmacies for the same drug and increase transparency for employers into PBM and carrier behavior that impacts their costs.