Colorado PDAB Sets First-in-Nation Payment Cap on Enbrel to Combat High Drug Prices

In a truly unprecedented move that signals a significant shift in the landscape of American drug pricing policy, Colorado has become the first state to implement an upper payment limit on a specific prescription drug. The state's Prescription Drug Affordability Board (PDAB) recently finalized this historic decision, establishing a cap on the cost of Amgen’s popular arthritis treatment, Enbrel. This pioneering step is highly noteworthy, marking the first-in-the-nation use of such a regulatory mechanism to contain prescription medicine spending, and it may serve as encouragement for other states considering similar strategies.

The PDAB’s decision creates an upper payment limit specifically for Enbrel, a blockbuster medication widely prescribed to state residents. This limit effectively sets a payment ceiling for both government agencies and commercial plans that provide health insurance within Colorado. The measure is expected to deliver crucial savings for consumers.

The cap has been set at $600 per unit. Crucially, this $600 limit per 50mg dose aligns with the maximum fair price that is slated to take effect within the Medicare program starting in January.

When calculating the annual cost, this payment ceiling dramatically changes the spending outlook. The new limit works out to approximately $30,350 per person annually. This figure compares favorably to what insurance plans in Colorado were paying on average in 2023, which stood at roughly $53,000 per person, based on state claims database information.

The measure has already garnered positive attention, particularly from groups like the Colorado Consumer Health Initiative, which praised the PDAB’s decision for its affordability focus and highlighted the bipartisan support behind this policy.

However, this landmark decision is not without opposition. While proponents celebrate the cap as a victory for consumers facing high drug prices, pharmacies have voiced their opposition. Furthermore, Amgen, the manufacturer of Enbrel, is actively pursuing ongoing legal challenges against Colorado’s imposition of this payment cap.

Ultimately, the PDAB’s vote, finalized on October 2, 2025, and reported shortly thereafter, demonstrates Colorado’s commitment to addressing the cost of vital medications. By setting this first-in-the-nation payment cap, Colorado has stepped onto the frontier of health policy, potentially inspiring broader action across the country.

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🔖 Sources

Colorado board makes first-in-the-nation move by setting a payment limit on an Amgen drug

Colorado becomes first state to cap prescription drug prices, starting with Enbrel

Colorado Adopts First State Payment Cap for Amgen’s Enbrel (1)

Consumer advocates praise Prescription Drug Affordability Board’s decision to set first-in-nation Upper Payment Limit on the expensive drug Enbrel

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