This op-ed by Allison Costello appeared on Colorado Newsline on October 24, 2023.
Physicians, like me, across Colorado advocated for the creation of a Prescription Drug Affordability Board in 2021, because we knew the status quo wasn’t working.
We knew a PDAB would be a meaningful solution, a true step toward more affordable prescription drugs for our patients.
This fall, Colorado’s new PDAB is nearing conclusion of its affordability reviews for five of the most expensive prescription drugs on the market. As a physician, I look forward to following this process and seeing how it brings down drug costs for my patients.
I am now watching the board do what it’s supposed to do: review expensive and unaffordable prescription drug costs, determine whether to set upper payment limits on the drugs, or take other actions to help address their high costs.
As a physician, I feel confident in the PDAB, because it is made up of independent, nonpartisan experts, with guidance from an advisory council of 15 people with different experiences in health care. The board listens to stakeholders — importantly patients and caregivers — and accepts public comment. It follows a rigorous review process to determine the affordability of certain drugs, recommends means to lower those costs, and, when deemed necessary and appropriate, sets upper payment limits.
Unfortunately, large pharmaceutical companies are working to undermine Colorado’s PDAB.
As they have done in other states with PDABs, these companies are attempting to use scare tactics and threats to squash our PDAB while protecting their full, enormous profits, without regards to the medication cost burden placed on patients like mine.
One of the more reprehensible scare tactics being employed is threatening to stop the production of certain drugs, including “orphan drugs,” a designation intended for drugs developed to treat rare diseases and conditions. This designation, however, has been abused by pharmaceutical corporations to receive federal tax credits, user fee waivers, and seven years of market exclusivity — all to protect their profits. Humira, the top-selling pharmaceutical in the world, was designated as an “orphan drug” until recently.
If patients cannot afford their medications, they are left to deal with their diseases on their own, often developing worsening symptoms and harder-to-treat conditions.
Orphan drugs are usually very expensive for patients and could be great candidates for review by the PDAB to set upper payment limits. It’s unconscionable that pharmaceutical companies would threaten to stop producing these life-saving drugs because of the PDABs. These companies make and sell these same drugs in other countries at lower prices. Why would they not continue to do so in the United States unless their goal was only to protect their profit margin?
To provide context, here are the price tags for some of the drugs the PDAB is currently reviewing:
- Genvoya, a medication to treat HIV, costs about $4,000 for a 30-day supply
- Cosentyx, a medication to treat psoriatic arthritis, a chronic condition, costs about $7,300 per dose
- Stelara, a medication to treat Crohn’s disease, a chronic condition, cost $25,000 for a two-month supply
When patients cannot afford these prices, tragically, they often do not take their medicine. Despite the visits to the office, tests, diagnoses, and treatment options, if patients cannot afford their medications, they are left to deal with their diseases on their own, often developing worsening symptoms and harder-to-treat conditions. These conditions often end up costing both the patient and the health care system much more money.
One in three Coloradans struggle to afford the drugs they have been prescribed, whether it is not filling prescriptions, skipping doses, or splitting pills. No Coloradan should have to choose between life-saving medicine and other life necessities.
That’s why doctors like me championed the PDAB and are continuing to support it. Our system should be working for patients, not pharmaceutical profits. The PDAB is doing just that.