Senate Bill 21-175 Summary

• Creates the Colorado Prescription Drug Affordability Review Board with five members appointed by the Governor to review and establish upper payment limits for unaffordable prescription drugs in Colorado.

• Requires carriers and pharmacy benefit managers to report drug pricing data to the all-payer health claims database beginning in 2022, including information on top drugs by volume, cost, price increases, and rebates.

• Authorizes the Board to conduct affordability reviews on brand-name drugs costing $30,000+ annually, biosimilar drugs not priced 15% below originals, and generic drugs costing $100+ with 200%+ price increases.

• Establishes that savings from upper payment limits must be used by carriers to reduce consumer costs, prioritizing reduction of out-of-pocket prescription drug costs.

• Effective January 1, 2022, makes it unlawful for any person to purchase or reimburse for a prescription drug above the Board-established upper payment limit; the Board may establish limits for up to 12 drugs per year for three years; the Board is repealed September 1, 2026.