By Celine Castronuovo
Amgen Inc.‘s blockbuster biologic Enbrel will be the first product to face a state-imposed health plan payment cap under a landmark vote by a key Colorado affordability panel Friday. …
Other patients and medical provider groups, however, have voiced concern to the board that a payment limit could affect health benefit designs and put some treatments out of reach.
“This decision fails to address real, patient-identified barriers to prescription affordability and adds complexity to a system already stacked against patients,” Tiffany Westrich-Robertson, founder of the Ensuring Access through Collaborative Health and Patient Inclusion Council, said in an emailed statement.
“We are disappointed that the Colorado PDAB disregarded the concerns of patients and adopted an unproven policy that is unlikely to lower patient out-of-pocket costs and may create new barriers to care,” Westrich-Robertson said, pointing to actions by health plans and pharmacy benefit managers that she said are some of the key drivers of high costs for patients.