Insights,

by Allison Schneider, MHA

ADVI Analysis: The Colorado Prescription Drug Affordability Meeting

On December 7, 2023, the Colorado Prescription Drug Affordability Board (PDAB) held a meeting to vote on Trikafta’s affordability, and review Genvoya and Enbrel’s affordability review data (link).

ADVI Angle

Summary

  • The Board reviewed voted unanimously (5-0) to determine Trikafta is not unaffordable.
    • “The use of Trikafta, consistent with the labeling approved by the FDA or with standard medical practice, is not unaffordable for Colorado consumers.”
      • Board discussion around Trikafta’s affordability was centered on the drug’s real-world evidence of clinical benefit, along with patient testimony. Board members were also in agreement that Trikafta is currently largely affordable due to Vertex’s patient assistance program.
    • Notably, the Board’s vote that Trikafta is affordable means that the PDAB cannot move forward with setting an upper payment limit (UPL) for the drug.
  • The Board was in agreement that there is still concern, as a whole, regarding the cost of Trikafta, and that they are in favor of taking another look at this drug for future affordability reviews if they begin to hear from the Cystic Fibrosis community that it is no longer affordable.
  • The next scheduled meeting is with the Prescription Drug Affordability Advisory Council, and will be held on January 25, 2024.

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Allison Schneider, MHA

Senior Manager