Fri., June 14, 2024
Contact:  Katie Reinisch, 303-653-1009,
Priya Telang, 720-443-6435,
Consumer advocates praise Prescription Drug Affordability Board’s decision to deem Cosentyx “Unaffordable”
DENVER – Coloradans know that life-changing drugs only work when people can afford them. This afternoon, consumer advocates responded to the decision announced at today’s meeting of the Prescription Drug Affordability Board (PDAB), the result of months-long reviews of a high-cost arthritis medication. Colorado’s PDAB ruled that Cosentyx is “unaffordable” after releasing an affordability review report last week. This decision is the last of the Board’s five affordability reviews.
The costs of prescription drugs rose by 159% over 10 years and Americans continue to pay 65%-85% more for critical medications than people in other countries. That’s why Colorado created a PDAB in 2021 to evaluate the affordability of the most expensive prescription drugs and, if determined unaffordable, to set an upper payment limit to bring down the cost.
Priya Telang, communications manager of the Colorado Consumer Health Initiative (CCHI) released the following statement:

“We’re pleased the Board deemed Cosentyx, a common and heavily-advertised medication used to treat psoriatic arthritis and other autoimmune diseases, “unaffordable” for patients today, especially when the annual out-of-pocket cost for Cosentyx for commercially insured Coloradans can range from $0 all the way up to $12,150.

According to 2022 APCD data, Cosentyx costs $46,948 per patient with an average annual out-of-pocket cost for patients with commercial insurance of $2,801. The PDAB report indicates from its launch in 2015 to 2024, Cosentyx’s wholesale acquisition costs have increased an outrageous 116%, an increase that has heavily outpaced inflation and that is inevitably passed on to all healthcare consumers through premiums and copays.
If more than 74 percent of patients with commercial insurance plans are accessing the drug exclusively through patient assistance programs, they can’t afford the drug. About a quarter of commercially insured Cosentyx patients in Colorado did not receive financial support from Novartis. This data does not reflect patients who have been recommended or prescribed Cosentyx but have been priced out of treatment even with Novartis’ “robust” patient assistance programs.
Both medical providers and Cosentyx patients who were surveyed by the PDAB expressed concerns about affordability. Of the surveyed patients, 80% indicated issues with cost.
A drug with such a high price that is utilized by over a thousand Coloradans is unaffordable for our system, and it’s clearly unaffordable for its patients.
We support the Board’s unaffordable ruling today and hope they move to set an upper payment limit on Cosentyx to reduce the financial weight that high-cost drugs have on our system and our patients. Patients need to be able to make medical decisions that are in the best interest of their health without having to factor in affordability.
Novartis has a complicated and problematic history, to say the least, and it cannot be trusted to reduce costs on its own or maintain its assistance programs. It has faced fines from France and Italy for engaging in anti-competitive activity and was raided by the Swiss government during an investigation into its patent acquisition practices.
We are pleased that the PDAB shares our concerns regarding Novartis’ drug pricing practices, regardless of their patient assistance programs.
We’re thankful that the Board is bringing much-needed transparency around pharmaceutical companies like Novartis, although we know there’s much more work to be done to hold Big Pharma accountable and ensure their drugs are accessible to patients. We believe the Board is working just as intended and we look forward to following their work to ensure all Coloradans can access the prescription drugs they need to live and thrive.
The Colorado Consumer Health Initiative believes that patients, and our system as a whole, need and deserve financial relief alongside their physical relief. The bottom line is that life-changing medications only work if patients can afford them.”
Colorado Consumer Health Initiative is a nonpartisan, nonprofit, membership-based group advocating for equitable access to high-quality, affordable health care. CCHI ​​serves Coloradans whose access to health care and financial security are compromised by structural barriers, affordability, poor benefits, or unfair business practices of the health care industry.
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