Colorado PDAB
Patient and Public Engagement
Individuals or organizations who wish to comment on Board activities are encouraged to review past Board meeting minutes, submitted public comments, and other relevant documents via the Board website.
Public Comment Submission
To provide verbal comments to the PDAB, please sign up using this link. To provide verbal comments to the PDAAC, please sign up using this link. Or email [email protected]. Comments will be limited to 2 minutes per person.
To provide written comments to the PDAB/PDAAC, please email [email protected] up to 48 hours before each meeting. Comments submitted after the 48-hour deadline will be considered for the following meeting.
Listserv
To receive PDAB and PDAAC updates directly in your inbox, click here. To subscribe, you will need to enter your email and then choose Updates From Divisions > Division of Insurance > Division of Insurance Prescription Drug Affordability Board.
For questions, comments, or accessibility issues, email DOI staff at [email protected].
Notably, the Board is currently accepting applications for both PDAB and PDAAC members.
Next Meetings
The next PDAB meeting will be on 9/18 and the next PDAAC meeting will be on a TBD date.
HealthHIV’s Comments
September 3, 2026
HealthHIV testified to the CO PDAAC on September 3, 2026 that that the patient toolkit describes the PDAB and PDAAC well, but gives patients too little context about the broader policy environment creating the experiences it asks them to report. It specifically asks about prior authorization, step therapy, denials and treatment delays, while providing little explanation of Medicaid, HCPF or other policies that may produce those barriers. The Chair rightly noted that PDAB statute limits the Council’s reach into Medicaid and other public formularies.
But that statutory boundary is not a patient boundary: Access barriers and downstream effects can cross Medicaid, Ryan White, ADAP, private coverage, and other parts of the care system even when PDAB itself has no authority over the policy that created them. A Medicaid policy can shift burden into Ryan White, ADAP, providers or other coverage as patients move through interconnected systems.
July 16, 2026
HealthHIV’s testified to the CO PDAAC on July 16, 2026 and connected the Toolkit’s focus on utilization management issues related to HCPF’s proposed Policy Action #6, which could reintroduce a preferred drug list (PDL) or further utilization management for selected HIV medications after July 2027. We encouraged the Council to recognize how policies outside of the PDAB’s direct authority can still shape patient experiences
May 15, 2026
HealthHIV testified to the CO PDAB on May 15, 2026 that HCPF advises the PDAB on drug affordability while also advancing Policy Action 6. The Board was asked to consider whether that Medicaid cost-containment proposal could shift costs and access burdens to patients, providers, Ryan White programs, and public health systems.
The forward question is whether the Board’s annual recommendations will connect decisions across state agencies. Otherwise, one agency may document access barriers while another creates similar barriers through cost-containment policy.
CO PDAB: September 3, 2026
Patient Engagement Toolkit
The Council is moving the Patient Engagement Toolkit toward the Board for finalization—with
staff describing it as substantially complete but also a “living document.” Its purpose is to help patients understand the PDAB and share experiences involving affordability and access.
Survey Design
The new PDAAC survey is intended to collect patient input earlier in drug selection and remain deliberately short, while more detailed health, financial and administrative impacts would be collected later. Council discussion raised important questions about health literacy, PHI and anonymity, insurance terminology, formulations, pharmacy availability, and assistance programs.
Affordability and Access Proved Difficult to
Separate
Members questioned whether issues such as an out-of-stock medication were “affordability” problems, then recognized that an in-network shortage can force a patient out-of-network and could increase costs. The discussion shows how coverage, access, and affordability interact in ways patients may not be able to neatly identify.
Takeaway
CO is trying to move patient engagement earlier in the affordability-review process, but the tools (the PDAB Education & Patient Engagement Toolkit & engagement process and Survey) are still catching up to the complexity of how patients actually experience affordability and access.
CO PDAAC: July 16, 2026
The draft Patient Engagement Toolkit expands affordability evidence beyond price to include denials, prior authorization, step therapy “fail first”), pharmacy problems, missed doses, switching effects, and household financial tradeoffs. The Toolkit provides for surveys, focus groups, listening sessions, and public comments to create more ways to participate, but the draft doesn’t yet explain how patient evidence will affect drug selection, affordability findings, or UPL decisions.
Patient engagement has the greatest value before drug selection and during the affordability review, when it can change the questions asked and the evidence examined. Input collected after the analysis is largely complete has less power to shape the outcome.
HCPF’s proposed Medicaid Policy Action 6 provides a concrete test for the toolkit. Because it could reintroduce prior authorization for selected HIV medications after July 2027, the Board should account for access barriers created through parallel state policies, not solely those attached to drugs under PDAB review.
CO PDAB Meeting: June 26, 2026
During the meeting, the Board engaged in Cosentyx Upper Payment Limit rulemaking. The Board acknowledged that the therapeutic alternatives aren’t one-size-fits-all, and testimony noted that Cosentyx treats conditions some comparators don’t. A lower-priced comparator may represent a narrower clinical product, not a workable substitute.
The hearing moved closer to setting a price while key access questions remained open, including which plans would be affected, how Medicaid would align, and whether formulary decisions could limit access. Those questions require implementation metrics and guardrails alongside the UPL.
Colorado PDAB Meeting: May 15, 2026
The draft activities report placed PBM practices, federal negotiation, and other cost policies around the Board’s work, signaling a wider affordability agenda than drug-by-drug upper payment limits.
The Colorado Department of Health Care Policy and Financing (HCPF) was seated as a member of the PDAAC. HCPF occupies two policy roles: it advises the PDAB on drug costs and utilization while advancing Policy Action 6, which could restore utilization management for selected HIV and behavioral health medications after July 2027.
HealthHIV testifed that HCPF advises the PDAB on drug affordability while also advancing Policy Action 6. The Board was asked to consider whether that Medicaid cost-containment proposal could shift costs and access burdens to patients, providers, Ryan White programs, and public health systems.
The forward question is whether the Board’s annual recommendations will connect decisions across state agencies. Otherwise, one agency may document access barriers while another creates similar barriers through cost-containment policy.
