Senate passes bill exempting many rare-disease and plasma therapies from PDAB review

The Colorado Senate on April 9 approved Senate Bill 140, a bill that exempts a class of rare-disease and certain plasma-derived therapies from affordability reviews by the Colorado Prescription Drug Affordability Review Board, sponsors said.

Sponsor Senator Frizzell told colleagues the bill responds to patient and caregiver testimony that PDAB reviews risk disrupting access to therapies for rare conditions. "This bill excludes rare disease and plasma treatments from PDAB review in line with the original advisory council's advice," Frizzell said, and added the draft would exempt roughly 31 drugs that also happen to have common indications.

Co-prime sponsor Senator Marchman said patients and families — ‘‘oftentimes moms, dads, and advocates’’ — urged protection while the state studies the impact of upper-payment limits. Marchman cited one illustrative case in which access to a targeted cystic fibrosis therapy reduced hospitalizations and saved hospital costs, saying the bill ‘‘provides hope for patients and families with rare diseases.’’

Opponents on the floor said the bill goes too far and risks undermining PDAB’s purpose. Senator Gonzales, who sponsored the 2021 law that created PDAB, said the board was established because Coloradans were making impossible choices between housing and medicine and warned that broad carve-outs would ‘‘hollow out’’ the board’s ability to lower drug costs. "Nobody's coming to save us when it comes to lowering the cost of prescription drugs but us," Gonzales said, urging a no vote.

Senator Wiseman, who said she voted against the bill in committee, questioned whether the bill's reliance on a federal statutory definition would create perverse incentives and cautioned that PDAB has only set an upper-payment limit for one drug to date, making the policy trade-offs complex.

Other senators expressed frustration with PDAB’s pace. Senator Roberts said the body has set a limit on only one medication in five years and that the program has cost roughly $1 million to date; she said she supported SB 140 to protect patients concerned about access.

After extended debate and references to prior 2024 changes aimed at increasing PDAB’s public input, the Senate adopted SB 140. The chair announced, "the ayes have it, and the bill is adopted." The transcript does not record a numeric final roll call at that moment.

What happens next: With Senate passage, the bill moves to the next steps specified by the legislative calendar (concurrence or transmission to the House, depending on where identical text may exist). The bill's supporters said their goal is to safeguard access for rare-disease patients while further study of the effects of upper-payment limits continues.