Colorado

Colorado board decides a pricey Novartis medicine is unaffordable

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A blockbuster arthritis drug from Novartis may face a limit on what Colorado health plans pay for the medicine after a state board determined the injectable treatment is “unaffordable” for patients.

The Colorado Prescription Drug Affordability Board voted Friday to grant the designation to Cosentyx, which is used to treat conditions such as plaque psoriasis and psoriatic arthritis. The vote means the board will decide in a follow-up meeting whether to pursue an upper payment limit for the drug, which an affordability review found cost an average of roughly $47,000 per patient in 2022.

In reaching its decision, the board noted that 26% of insurance carriers who submitted information to a state claims database reported Cosentyx was one of the top 15 prescription drugs that led to increased premiums. Yet two years ago, Cosentyx was used by 1,128 residents compared to all of the available alternatives in the same class of medicines.

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