Colorado Sued by Amgen Over PDAB Price Cap on Enbrel

November 13, 2025

EGWP marketplace medicaid Medicare

Amgen, the manufacturer of Enbrel (a rheumatoid arthritis and ankylosing spondylitis treatment), filed a lawsuit against the Colorado Prescription Drug Affordability Review Board (PDAB) after the board determined Enbrel to be “unaffordable” and established an upper payment limit (UPL) of $600 per 50mg unit of the drug. In the suit, Amgen claims the UPL, which imposes price caps on the sale or purchase of Enbrel beginning Jan. 1, 2027, is unconstitutional and jeopardizes patient access to the drug.

Amgen previously sued the PDAB when the board was first considering a UPL, but the lawsuit was dismissed by a federal judge on the grounds that the company had not demonstrated it would likely suffer harm from the Board’s actions. The case is scheduled for a preliminary hearing in Jan. 2026. Colorado is the first state to set a UPL through a PDAB.

survey results

Take the 1-Minute survey

Thank you for being a valued reader of Regulated Times. Take our brief, anonymous survey in less than one minute and help shape the future of Regulated Times.

As we continue to evolve the newsletter, we’d love to hear your thoughts. Your feedback will help us better understand what content is most valuable, whether the current publication frequency is meeting your needs, and how we can improve your overall experience.
read more >

June 19, 2026

EGWP marketplace medicaid Medicare

legislation

Bicameral Patients before Monopolies Act reintroduced

On May 13, bipartisan lawmakers in the House and Senate reintroduced the Patients Before Monopolies (PBM) Act (S.4509/H.R.8779), legislation that would prohibit common ownership of PBMs, insurers, and pharmacies. Sponsored by Sens. Warren (D-MA) and Josh Hawley (R-MO) alongside Reps. Diana Harshbarger (R-TN) and Jake Auchincloss (D-MA), the bill would require impacted organizations to divest […]
read more >

June 10, 2026

EGWP marketplace medicaid Medicare

legislation

CMS announces ePA acceleration initiative, democrats seek to repeal WISeR Model

The Centers for Medicare & Medicaid Services (CMS) is advancing its electronic prior authorization (ePA) efforts through a newly established Electronic Prior Authorization Acceleration initiative to address key challenges and drive solutions ahead of 2027 requirements. To date, 29 health care organizations – including health systems, electronic health record developers, physician practices, networks, and digital health […]
read more >

June 10, 2026

EGWP marketplace medicaid Medicare

You may also like