Colorado beats U.S. Congress to the punch on critical PBM reform. Congress must finish the job of PBM reform NOW.

Colorado State Capitol

Colorado beats U.S. Congress to the punch on critical PBM reform. Congress must finish the job of PBM reform NOW.

Colorado State Capitol

Over the past five years, several not-so-productive bills have passed the Colorado legislature to supposedly lower prescription drug prices. This legislative session, however, something really meaningful happened for Colorado patients.

The Colorado General Assembly passed House Bill 23-1201, which prohibits one of the many underhanded practices pharmacy benefit managers, known as “PBMs”, use to artificially inflate profits and drive up the cost of prescription medicines for everyone.

HB23-1201 was a bipartisan bill sponsored by Colorado Representatives Daugherty and Soper as well as Senators Mullica and Smallwood. The bill prohibits PBMs from further using ‘spread pricing.’ In simple terms, this is the practice of  having the PBM charge its client – an insurance company or company that self-insures its employees –  a higher price than the PBM pays the pharmacy for dispensing the same drug to the same covered member.

In other words, PBMs have been charging the equivalent of a hotel ‘resort fee,’ a meaningless mark-up that provides nothing but increased profits that in turn drives up prescription drug prices while shorting local pharmacists. It’s a lose-lose-lose scheme that our state legislature finally outlawed. The bill now sits on Gov. Polis’ desk, and we urge its immediate signing.

Last year the top PBMS — companies who claim their role is to save Americans money on the skyrocketing cost of medicines — took in $450,000,000,000. That’s $450 billion, $50 billion more than the top six drug makers earned in 2021.

They derive this windfall from an impenetrable web of rigged contracts and high-pressure tactics that would make a crime boss blush. A blizzard of reports by Congress, non-partisan groups, and industry experts have highlighted these practices and called for a massive overhaul of the PBM system.

Thankfully a hearing is set for Thursday, May 11, to consolidate PBM reform efforts and write meaningful legislation to reform the PBM’s unsavory practices.

Senators Bernie Sanders (D-VT) and William Cassidy (R-LA) are leading the charge, with Colorado Senator John Hickenlooper as a member of the HELP Committee. They need our support against the intense pressure coming from the battalion of lobbyists that we – America’s prescription drug patients – help pay for.

CHAIN backs the herculean effort to crack down on the PBM monopoly and go after the real cause of skyrocketing drug prices in America. And we urge Colorado’s US Senators Hickenlooper and Bennet to be front and center in finishing the job Congress has started.

To learn more, go here and check out our ads on Twitter:

Heartfelt Congratulations and Gratitude to the 2023 National Civic Bee Participants in Arvada, CO

2023 National Civic Bee in Arvada, Colorado

Heartfelt Congratulations and Gratitude to the 2023 National Civic Bee Participants in Arvada, CO

2023 National Civic Bee in Arvada, Colorado

On behalf of CHAIN, we would like to extend our warmest congratulations to each and every one of you who participated in the National Civic Bee held in Arvada, Colorado on April 18th, 2023. Your dedication, enthusiasm, and knowledge of civics have contributed to the success of this incredible event.

We know that preparing for the National Civic Bee is no small feat. It takes countless hours of hard work, research, and practice to attain the level of expertise displayed by all of you. Your passion for civic education and your commitment to fostering an informed and engaged citizenry are truly inspiring. Your accomplishments reflect not only your individual talents but also the support and encouragement from your family, friends, educators, and mentors.

As you move forward, we hope that you will continue to champion the importance of civic education in your communities. You have demonstrated that you are not only well-informed citizens but also engaged and responsible members of society. The future of our democracy depends on individuals like you, who are committed to upholding the values and principles that bind us together.

Once again, congratulations on your achievements and thank you for your participation in the National Civic Bee. We wish you the best of luck in your future endeavors, and we are confident that you will continue to make a positive impact in your communities.

Critical Action on April 19th Battling the Counterproductive HB23-1225, “Extend and Modify the Prescription Drug Affordability Board

Colorado Legislative Session

Critical Action o April 19th Battling the Counterproductive HB23-1225, "Extend and Modify the Prescription Drug Affordability Board

Colorado Legislative Session

Tomorrow the Colorado Senate Health & Human Services Committee will hold its hearing on HB23-1225 (the “Bride of PDAB”).

Colorado consumers, healthcare providers and business organizations are part of a broad coalition opposed to this ill-advised legislation.

They – and we – have already seen how Colorado’s drug price control bureaucracy – the Prescription Drug Affordability Board – has cost taxpayers an average of $80,000 a month to date with zero savings, while Coloradans dependent on life-saving drugs have NO assurances around drug accessibility and the likelihood of access being compromised.
Now, Colorado lawmakers are looking to expand PDAB through HB23-1225. The bill removes the two key guardrails of the original program that legislators agreed to, to ensure that the potential damage of the PDAB program could be mitigated. Instead, HB23-1225 gives PDAB carte blanche to set an Upper Payment Limit for any qualified drug (as opposed to the original twelve drug limit). We should be going in the opposite direction.
Upper Payment Limits set the price that physicians, hospitals, pharmacists and clinics are allowed to pay for certain drugs, regardless of what the drug actually costs. Mandating what providers can pay for a drug is tantamount to making it unavailable if the purchase price exceeds the state-controlled price. This unproven and potentially damaging approach contrasts greatly to the action other states are taking to generate real savings for drug patients.

For just one example of the risks and concerns being created by the PDAB legislation, read through this recent opinion piece by patient advocate Kris Garcia and learn how PDAB could very well endanger  access to life-saving drugs.

CHAIN opposes HB-1225 and is continuing to educate lawmakers about the scores of unanswered questions on how this bill may compromise patient access to life-saving drugs and how we can be assured that more taxpayer dollars aren’t squandered in delivering ZERO savings for Colorado patients.

PLEASE JOIN WITH US IN OPPOSING HB23-1225, “The Bride of PDAB”.  Contact your legislators and link up with our Twitter stream with #ZeroSavingsCO.

Lifesaving Biomarker Testing Bill HB23-1110 Supported by CHAIN Falls Short

Colorado State Capital

Lifesaving Biomarker Testing Bill HB23-1110 Supported by CHAIN Falls Short

Colorado State Capital

CHAIN has been actively supporting the passage of House Bill 23-1110, the Biomarker Bill that would have ensured every Coloradan had equal access to advanced disease testing and precision medicine.

Despite the advocacy from multiple patient groups, including the American Cancer Society, HB23-1110 is slated to die on the House calendar – meaning that it will receive no further action this session.

CHAIN is proud to have supported the American Cancer Society in advancing this critical legislation.  Every Colorado patient should have access to these increasingly vital treatments for cancer and other other life threatening conditions.

At the same time, improving access to biomarker testing is critical to  advancing health equity. Currently, patients who are insured by Medicaid, Black, have lower incomes, or receive treatment outside of academic medical centers are all less likely to benefit from biomarker testing. A key objective of this legislation is to help expand access to these populations, so that more Coloradans can access biomarker testing and the most effective treatments for their condition.

We look forward to supporting advocates in next year’s legislative session should this initiative be re-introduced.

2023 National Civics Bee Competition Coming to Arvada Today, April 18th

National Civics Bee in Arvada, Colorado

2023 National Civics Bee Competition Coming to Arvada Today, April 18th

National Civics Bee in Arvada, Colorado

CHAIN is proud to sponsor the 2023 National Civics Bee competition in Arvada!

The National Civics Bee is an annual competition that takes place in partnership with the Colorado Chamber and local chambers of commerce across the United States.

A core mission of CHAIN is to engage the public in dialogue over important issues impacting our communities. The National Civics Bee, part of the U.S. Chamber Foundation’s Civic Trust initiative, aligns with our purpose to engage in civic life and encourage a civically connected community and nation.

On April 18 in Arvada, nine local middle schoolers selected by a panel of community-based judges will compete in this fast-paced live competition at Revive Church, testing their civics knowledge. The winners (and their schools) will be recognized in the community and receive cash prizes, and the top three students will also proceed to the state competition!

This is one of many pilot National Civics Bee competitions promoted by the U.S. Chamber of Commerce Foundation.

This event is complimentary! Join CHAIN on April 18 to celebrate civic engagement and knowledge amongst the future leaders of Jefferson County!

Register here:

Passing HB23-1110 Means Better Care, Healthier Outcomes and Millions in Savings for Patients

Passing HB23-1110 Means Better Care, Healthier Outcomes and Millions in Savings for Patients

HB23-1110 - The "Biomarker Bill" - awaits next action after overwhelmingly passing in the House Health & Insurance Committee

Stakeholders across the state, including the American Cancer Society (“ACS”), have mobilized on this critical piece of legislation.  The bill would guarantee the availability of biomarker testing and precision medicine for cancer patients in addition to Colorado patients with other life-threatening diseases.

Data from the ACS across the United States shows a deplorable gap in accessibility to precision medicine, especially among the underserved and underinsured.  Almost 25% of patients needing these types of cutting-edge tests end up going without – risking their health – and possibly misdiagnosis, mistreatment and worse.  Most of these cases involve lack of insurance approval as the primary impediment to getting needed care.

One patient, Rebecca Givens, testified in favor of HB23-1110 and shared her story:
I was diagnosed with an aggressive form of cancer Thanksgiving of 2019. This diagnosis was terrifying, confusing, time consuming and very expensive. It led to a year of treatment with chemotherapy, surgery and biologic therapy following surgery. And after all of this, I believed I was cancer free…”

Then I learned at my post-cancer follow-up appointment that the values on the standard tumor marker blood test came back elevated. . . . and I was left with large out-of-pocket costs that I had to cover…”

My doctor then told me about comprehensive biomarker testing, a highly sensitive and personalized test that could reveal if my cancer had reoccurred or if new cancer cells were present with the added benefit that the test would not show a false positive based on my rheumatoid arthritis diagnosis. I jumped at the chance to get this testing despite its very high cost that was not covered by my group health insurance plan. Being fortunate enough to have the financial resources, I immediately determined to move forward with this critical test.”

The results of my biomarker testing were negative. I finally knew I was cancer free. Had I received comprehensive biomarker testing earlier in my cancer journey, I would have not had to endure the additional diagnostic tests and procedures, saving me precious time and stress, and reducing the cost of my care overall.”

Rebecca’s story, despite the anguish, ended well.  But how many Colorado patients may not be as fortunate to afford extra care to get to the right diagnosis?  One more is too many.

By lowering misdiagnosis and improving care, precision medicine could dramatically lower the cost of care not only in Colorado but across the United States.  For colorectal cancer alone, A 2012 study found that it is possible to increase expected overall survival while saving approximately $7,500 per patient when compared to using non-biomarker-directed treatment25.  Another research project estimated that using specific biomarker testing could save more than $600 million by ensuring that only those metastatic colorectal cancer patients likely to benefit from a specific therapy would receive it.

In spite of the overwhelming public good and support of leading health and patient advocacy groups, passage of HB23-1110 is not assured.  The bill’s next stop will likely be the House Appropriations Committee.

CHAIN is urging every Coloradan to contact their state lawmakers and encourage them to support physical and financial wellbeing in our state by voting YES on HB23-1110.

Scarier Than the Original! HB23-1225: PDAB “MODERNIZATION”

Scarier Than the Original! HB23-1225: PDAB “MODERNIZATION”

Scarier Than the Original! HB23-1225: PDAB “MODERNIZATION”

Scarier Than the Original! HB23-1225: PDAB “MODERNIZATION”

“Bride of Prescription Drug Affordability Board” is Scaring Coloradans Silly

  • Access compromised to life saving medicines.
  • Zero savings for beleaguered drug patients.
  • No relief from crushing out of pocket medical costs.
  • Squeezing doctors, pharmacists, hospitals, and clinics in a brutal ethical vice.
  • Squandering $81,000 PER MONTH in taxpayer money.

Welcome to Colorado’s emerging “Prescription Drug Affordability Board” (PDAB) nightmare.

After 20 months since the original PDAB bill SB21-175 passed, PDAB bureaucracy is floundering. Not one penny has been saved for drug consumers. Not one drug has been subjected to review. And taxpayers have footed the bill to the tune of $81,000 per month.

Now comes HB23-1225 – the “Bride of PDAB” — passed today out of its first committee hearing (House Health & Insurance) – with a 8-3 vote.

This bill should scare Coloradans silly. “The Bride of PDAB” strips out the only two guardrails standing between Coloradans and a bureaucracy run amok. The bill gives the Board power over an UNLIMITED number of drugs instead of the current limit of 12. And it DOUBLES the life of the PDAB program from five to ten years. Already able to wreak massive havoc for patients, providers, and taxpayers, PDAB would become the “Godzilla” of health care nightmares under HB23-1225.

Over 30 Colorado doctors, health care provers, patients, and community members testified in opposition to the original PDAB bill (SB21-175) fearing a wave of negative impacts, staying well into the night to voice objections about this unproven policy.

Thankfully the cost overruns, backward logic, and bureaucratic fog of PDAB have kept the policy being implemented so far.  But HB23-1225 is set to unleash the proverbial hounds and waste even more time, energy and taxpayer dollars.

We urge Coloradans to contact their legislators to say enough is enough.  Leave the “Bride of PDAB” at the altar and vote no on HB23-1225.

The table below outlines PDAB by the numbers:

The table below outlines PDAB by the numbers:

  • What level of savings can patients expect to see from implementation of PDAB policies and when can they expect to see them?  Will patients see any reduction in their out-of-pocket costs?
  • How do Colorado patients and their families get assurance that the backward logic of the UPL does not result in patients being denied access to hundreds of medications because providers won’t be allowed to access the drugs or face legal action if they do?
  • What alternatives will be available to patients if a needed medication is denied to them?
  • To what extent would PDAB exacerbate the already growing health inequities between high and low income patients when those with means can travel outside Colorado for a drug not available under the UPL, and those without means will have a harder time doing so?
  • How can the state legislature, research staff, and HCPF leadership justify the notion that no additional fiscal support will be required for a DOUBLING of PDAB’s sunset term, when the current spend rate for the program is $81,000 a month. Will the four full time state employees now assigned to PDAB go away?  Will the board not spend a penny during its five-year extension?

Read Jennifer Churchfield’s written testimony re: HB23-1225 here:

We want to hear from you!  What are your thoughts about HB23-1225?  Please write to us at 

Join us in celebrating the passage of HB23-1071, a bill which certifies psychologists to prescribe and administer psychotropic medications

Colorado legislature OKs allowing psychologists to prescribe medication

Colorado legislature OKs allowing psychologists to prescribe medication

Colorado legislature OKs allowing psychologists to prescribe medication

Join us in celebrating the passage of HB23-1071, a bill which certifies psychologists to prescribe and administer psychotropic medications (which treat depression, anxiety, sleep disorders, and other mental health conditions). The bill now goes to @GovofCO for his consideration. 

This bill is welcome news, as it is a bipartisan, commonsense measure that will actually connect Coloradans to the care they need in a faster and more cost efficient manner than today’s system currently allows. (Now, psychologists can’t prescribe but must refer patients to a psychiatrist or medical doctor for prescriptions. This bill will change that.)

Thanks to the Colorado Psychological Association, Colorado Counseling Association, National Association of Social Workers, Colorado Center on Law and Policy, Colorado Consumer Health Initiative, Colorado Cross-Disability Coalition, AARP and Healthier Colorado for backing this important bill. 🙌

#CoPolitics #CoLeg 

More here via @Colo_Politics

Chain 2023 Action Agenda


In 2023, CHAIN (Colorado Health Advocacy & Information Network) will expand efforts and outreach for finding common ground on common sense health care solutions. Our key action items include:


Unfair and uncompetitive practices limit patient care and drive-up healthcare costs. CHAIN will work to reform or curtail these and other strategies that some healthcare entities use for their benefit but not necessarily for patients: 

    • Stem the unchecked payment of ‘rebates’ by drug makers to PBMs and insurance companies in order to gain approval for drugs to be covered and distributed. Can Rebate Reform Help Consumers? – CHAIN (
    • Oppose the growing misuse of prior authorization by health insurance providers to deny critically needed care.  
    • Push back on the proliferation of high deductible health plans and faltering of traditional health insurance to provide adequate coverage.  


The Coronavirus vaccine and overall response proved indisputably that American innovation and technology leads the world.  Massive and ill-conceived takeovers of parts of the American healthcare system threaten that innovation.  CHAIN will fight to protect America’s scientific leadership and push back on the kinds of government overreach that threaten the very lifeblood of cures and treatments, including: 

    • Systemic healthcare takeover proposals such as single-payer insurance plans or drug-price control mechanisms;
    • Policies such as Rep. Nancy Pelosi’s HB 1 or the Medicare drug negotiation provisions in the Building a Better America Act that substitutes open competition for socialized health care policies;
    • Nationalized drug pricing programs – as in Canada, Britain and other countries – that compel biotech companies to sell at below market costs which dampens life-saving innovation and compromises patient access;
    • Push for alternative approaches like the Reduced Costs and Continued Cares Act (RCCCA) from moderate Congressional democrats, the sensible alternative to H.R. 3 that is designed to lower costs without trampling on American innovation.


Too often, well-intended health care policies end up health care travesties for the very people the policies are intended to help.  CHAIN will highlight the successes and failures in government healthcare initiatives and endeavor to spotlight practices already benefiting patients: 

    • Restore transparency and accountability to the $29b federal 340B drug program, designed to help underserved patients but now has veered off course into filling the coffers of healthcare providers. 
    • Facilitate conversations and awareness around practices such as value-based pricing, which bases the cost of prescription drugs on outcomes delivered.  
    • Highlight emerging practices such as Pfizer’s recently enacted pledge to refund patients if their new lung cancer drug does not perform as intended. 
    • Call “time out” on proposals to import drugs from Canada or other nations, a policy that has cost Coloradans $2m since passage in 2020 and wasted millions more in federal resources while producing nothing in the way of savings for consumers. 
    • Continue speaking out against Colorado’s Prescription Drug Affordability board (PDAB) — an unproven and costly policy that experts say will compromise access to life saving medicines.


Coloradans can rightfully take pride in a burgeoning bioscience community that creates scientific breakthroughs in health care.  Here and across the country, world-leading American scientists work to bring cures and treatments for our most devastating diseases.  Simultaneously, policy experts continue to research ways to provide better health care with increasing cost of compromising access.  CHAIN joins other science and research-based organizations supporting these efforts to:  

How Bennet will help combat ‘superbugs’ in a post-COVID world

Christine MacBrayne

How Bennet will help combat 'superbugs' in a post-COVID world

Christine MacBrayne

Christine MacBrayne

The early days of the COVID-19 pandemic sparked widespread alarm as to how infectious diseases spread. For most of us, COVID-19 was the first pandemic we lived through. Never had a sneeze or a cough from someone within six feet of us felt so dangerous and potentially infectious, or even deadly.

Public health experts and medical professionals like myself have learned a lot since COVID halted our day-to-day lives. The lessons learned are helping America’s infectious disease community identify and address other vulnerabilities in our health care system, leading to a rapidly growing recognition of the next new major threat in the United States healthcare system.

This threat is ‘superbugs.’