RAAP: Colorado PDAB Chooses Politics Over Patent Access

OP-ED Highlights CO PDAB Failings

WASHINGTON, Oct. 16, 2025 /PRNewswire/ -- Upper payment limits (UPL) present clear challenges and dangers to patients because of its potential impact on access to life saving drugs. In an Op-Ed, written on behalf of the Rare Access Action Project (RAAP) by Bridget Dandaraw-Seritt, she details this exact challenge she now faces because of Colorado's recent Prescription Drug Affordability Board (PDAB) reimbursement decision regarding "Enbrel." (Enbrel is a biologic primarily used to treat signs and symptoms of moderate to severe rheumatoid arthritis (RA)).

In the Op-Ed, Bridget writes, "Patients, providers, pharmacists, and other knowledgeable stakeholders warned the State of Colorado about the challenges and dangers of an upper payment limit (UPL) since Colorado's PDAB was first discussed. Despite the warning, Colorado's PDAB recently announced that Enbrel™ was unaffordable and imposed an upper payment limit. 

The PDAB based its UPL on the Medicare Part D maximum fair price (MFP) that was placed on the product for Medicare beneficiaries. That price goes into effect in January 2026."

Bridget founded Advocates for Compassionate Therapy Now, with the goal to connect, educate, and support Colorado's patient community. RAAP applauds the work Bridget has done on behalf of the rare disease community and is grateful for her involvement with RAAP.

Mike Eging, the Executive Director of the Rare Access Action Project (RAAP) stated, "Bridget's Op-Ed details the very real problems MFP can create through PDABs. As Bridget highlights, by tying the upper payment limit to MFP, the Colorado PDAB has limited the amount payers can reimburse for that medicine, even though the PDAB in their own research noted that most patients pay copays of $50 or less out of pocket for the product. This action does nothing to lower patient out-of-pocket costs and could cause plans to switch patients to a different product – which may not yield the same results."

The Op-Ed can be read in its entirety here: https://www.rareaccessactionproject.org/state-policies/pdab/the-dangers-and-challenges-of-upper-payment-limits-upl/

Eging concluded, "Colorado's PDAB decision highlights the problem RAAP has been warning legislators around the country about, adopting an UPL to score political points without doing any additional homework on the access issues to medicines currently available to patients. That's something rare patients and families cannot afford."

RAAP, the Rare Access Action Project , is a coalition of patient and life sciences stakeholders that explore creative policy solutions to address structural issues in access and coverage. Our priority is to help ensure rare disease patients have access to the care and treatments they need. RAAP is a registered 501 c4 non-profit organization.

SOURCE Rare Access Action Project (RAAP)