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Legislative Year: 2021 Change
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Bill Detail: SB21-175

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Title Prescription Drug Affordability Review Board
Status Governor Signed (06/16/2021)
Bill Subjects
  • Health Care & Health Insurance
House Sponsors C. Kennedy (D)
Y. Caraveo (D)
Senate Sponsors J. Gonzales (D)
S. Jaquez Lewis (D)
House Committee Health and Insurance
Senate Committee Health and Human Services
Date Introduced 03/08/2021
Summary

The bill creates the Colorado prescription drug affordability review
board (board) as an independent unit of state government and requires the
board to perform affordability reviews of prescription drugs and establish
upper payment limits for prescription drugs the board determines are
unaffordable for Colorado consumers. The board is also required to
promulgate rules as necessary for its purposes.
The board shall determine by rule the methodology for establishing
an upper payment limit for a prescription drug. An upper payment limit
applies to all purchases of and payer reimbursements for the prescription
drug dispensed or administered to individuals in the state in person, by
mail, or by other means. Any savings generated for a health benefit plan
as a result of an upper payment limit established by the board must be
used by the carrier that issued the health benefit plan to reduce costs to
consumers.
On and after January 1, 2022, the bill prohibits any purchase or
payer reimbursement for a prescription drug from exceeding an upper
payment limit established by the board for that prescription drug. A
person who violates the prohibition may be subject to a fine of $1,000 for
each violation. Final board decisions are subject to judicial review.
A person aggrieved by a decision of the board may appeal the
decision within 60 days. The board shall consider the appeal and issue a
final decision concerning the appeal within 60 days after the board
receives the appeal.
Any prescription drug manufacturer (manufacturer) that intends to
withdraw a prescription drug for which the board has established an upper
payment limit from sale or distribution within the state must notify, at
least 180 days before the withdrawal:
  • The commissioner;
  • The attorney general; and
  • Each entity in the state with which the manufacturer has
contracted for the sale or distribution of the prescription
drug.
A manufacturer who fails to comply with the notice requirement may be
required to pay a penalty of up to $500,000.
For all prescription drugs dispensed at a pharmacy and paid for by
a carrier during the immediately preceding calendar year, the bill requires
each carrier and each pharmacy benefit management firm acting on behalf
of a carrier to report certain information.
The bill creates the Colorado prescription drug affordability
advisory council to provide stakeholder input to the board.
The board must submit an annual report to the governor and to
subject matter committees of the general assembly summarizing the
activities of the board during the preceding calendar year.

Committee Reports
with Amendments
Full Text
Full Text of Bill (pdf) (most recent)
Fiscal Notes Fiscal Notes (05/18/2021) (most recent)  
Additional Bill Documents Bill Documents
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  • Past fiscal notes
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