The new session of the Colorado legislature has again placed health care issues at the top of its agenda. The challenge many Colorado patients are facing, however, is the potential impact, and unintended consequences, of drug cost measures passed in previous years. 

Patients across our state are focused on the state’s prescription drug cost-setting panel which was established in 2021 but didn’t have its inaugural meeting until late last year. The Prescription Drug Affordability Board (PDAB) was created to review — and potentially set — reimbursement prices for certain medications. Yet, years later, it remains an unproven experiment. 

Though its stated mission is to address high prescription drug costs, PDAB has raised deep and continuing concerns about steps that would actually reduce access to vital medications patients need while not bringing about the hoped-for cost savings at the prescription counter. 

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This is one of the reasons why a coalition of a dozen patient organizations formed Colorado Patients Taking Action. 

The initial PDAB efforts, including public meetings, have surfaced a need for increased transparency, accountability and more responsiveness to Colorado patients and other stakeholders. When we examine its operations do date, the phrase, “building the plane while flying,” comes to mind.

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Patients have been providing a wide range of in-depth, detailed comments to PDAB members and staff about the practical impact of the board’s decision-making on patients suffering from life-threatening and chronic diseases. A priority for patient groups is to increase the flow of comments to the panel so members have a full and accurate picture of the potential impacts of their decisions in the real world. 

Throughout the process to date, many patient groups believe their collective voice must be strengthened. 

For that reason, a top priority for many of the coalition partners is to secure at least one dedicated seat on the board for Colorado patients. On virtually every appointed, regulatory board in the state, seats are reserved for the groups most affected by a board’s decisions. 

Yet it was a clear mistake to create PDAB  — which will make decisions that could impact tens of thousands of Colorado patients — and not reserve one seat for bona fide Colorado patients. A patient sitting in every meeting, empowered not only with a voice, but with a vote, could help enhance PDAB’s responsiveness and effectiveness.

For example, like other appointed boards, PDAB is not directly accountable to patients, health care providers or the public. We’re interested in fostering a more robust dialogue among patients, providers and other stakeholders with PDAB members. Having a patient member of the panel would help achieve that goal. 

There are also specific policy concerns PDAB could use that are raising red flags among patients. Groups have been urging the panel to eliminate any use of artificial bureaucratic metrics that could limit access to medicines. The Quality of Life Year (QALY) cost-benefit analysis can prioritize access for some patients over others, which creates unnecessary discrimination. 

Patients have also expressed concerns PDAB members could be rushing headlong into price setting without considering the complexities of — and impact on — the entire drug supply chain. As we saw during COVID, seemingly minor decisions affecting one part of the supply chain can have very large, unexpected ripple effects in other areas, and consumers suffer the negative effects. All questions about how the PDAB process could affect the availability of critically needed medicines for patients must be answered before PDAB sets a drug’s price. 

Focusing on high drug costs is an important priority for state government. By giving a stronger voice to Colorado patients, PDAB members could ensure they are shaping policies with patients, not just for patients. 

Bridget Dandaraw-Seritt is the founder of Advocates for Compassionate Therapy Now, an organization that works with medically complex families across Colorado to help foster a healthy community, help support their needs and keep them informed of Colorado policies that could impact their lives.