Colorado board makes first-in-nation move, sets payment limit on Amgen drug

In a first-in-the-nation move, a Colorado panel has voted to limit what health plans in the state will pay for a costly arthritis treatment, a step that may encourage other states to pursue similar strategies to contain spending on prescription medicines.

The landmark vote by the Colorado Prescription Drug Affordability Board creates an upper payment limit for the widely prescribed Enbrel medication, which is a blockbuster treatment sold by Amgen. As a practical matter, the decision establishes a payment ceiling for government agencies and commercial plans that provide health insurance for state residents.

The limit was set at $600 per unit, which is also the current maximum fair price that is set to go into effect in the Medicare program in January. This works out to approximately $30,350 a year per person, compared with roughly $53,000 that the average insurance plan in the state paid per person in 2023, according to state claims database.