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:


Saam Golgoon

Saam Golgoon

Saam Golgoon

Saam Golgoon is a multi-talented professional with a diverse range of professional experiences and a deep commitment to community service. Born and raised in Iran, Saam moved to the United States at the age of 15 to pursue his dreams of a better life. Since then, he has built an impressive career that has spanned several different industries including Parks & Recreation, Real Estate, Arts, Music, Entertainment, and Marketing & Advertising.

Saam’s first career was in the Parks & Recreation industry. He worked as an Aquatics Supervisor for the Town of Breckenridge, then as an Aquatics Director for the South Park Recreation Center. He also served as the South Park BMX Track Director, gaining valuable experience in event management and community outreach.

Saam’s passion for the arts and music led him to the Cultural Arts Director position at the Town of Breckenridge. There, he worked to promote cultural events and support local artists. Saam then transitioned into the Entertainment industry, working as the Director of Operation/Facilities/Technology at Breckenridge Creative Arts. In this role, he helped to develop and manage events and venues that showcased local and international talent.

Saam’s entrepreneurial and philanthropic spirit led him to found World Music Development, a 501(c)(3) nonprofit organization that aims to promote cross-cultural understanding through music. As President and CEO, Saam has worked to establish partnerships with musicians, venues, and festivals around the world.

Saam is a true champion of community service and has dedicated a significant portion of his time to volunteer work throughout his career. He has been actively involved with various organizations, including the American Red Cross, Red White and Blue Fire Department, Summit Rescue Group, and the Northwest Fire Department.

Saam has served as a volunteer instructor and disaster relief team member for the American Red Cross, where he has helped train individuals in life-saving skills and has assisted in disaster relief efforts in his local community and beyond. He has also been a volunteer firefighter with the Red White and Blue Fire Department in Breckenridge and the Northwest Fire District in Fairplay, responding to emergency calls and helping to keep his community safe. In addition to his firefighting work, Saam has also served as a volunteer Search & Rescue medic and dog handler with the Summit Rescue Group, where he has participated in rescue missions and helped save lives.

Saam’s passion for community service extends beyond his work as a first responder. He has also served as a town council member for the Town of Alma for 10 years, where he has worked tirelessly to make his community a better place to live. He has been involved in a range of initiatives to improve public safety, promote economic development, and support local businesses.

Currently, Saam serves as the Executive Director for the South Park Parks & Recreation District, where he oversees the management of local parks and recreational facilities and programs. He also serves as the Mayor of the Town of Alma, Colorado, where he continues to work tirelessly promoting economic development and community engagement.

His passion for community service is evident in his involvement with CHAIN (Colorado Health Advocacy Information Network), where he currently serves as a member of their Advisory Committee. CHAIN is an organization that works to improve healthcare access and affordability for Colorado residents.

Throughout his career, Saam has demonstrated as a true visionary and community leader. He has a unique ability to bring people together, foster collaboration, and drive positive change. Saam is a testament to the power of hard work, determination, and a genuine passion for making a difference in the world.


Nancy Littleford


Nancy Littleford

Nancy Littleford has a varied career with a unique depth and breadth of healthcare experience spanning more than 20 years. As a Licensed Professional Counselor since 1998, her education, training and experience in behavioral health have allowed her to be an advocate, change-agent and tireless relationship-builder. Nancy has spent the past 12 years immersed in population and community health initiatives in a variety of roles, including disease management programs, and corporate wellness, along with consulting and community health improvement projects. Healthcare is a very complicated system that requires skilled and diligent stakeholder engagement. Having served in multiple roles within that system, Nancy understands how best to build consensus and drive positive change.


Jennifer Churchfield - CHAIN

Jennifer Churchfield

Jennifer Churchfield - CHAIN

Jennifer Churchfield has partnered with public and private organizations for over 25 years. She is currently the co-chair of Front Range PharmaLogic. She served Arapahoe County as the Communications Director for Arapahoe Responsible Energy Advocates. Jennifer was elected for two-terms to the Cherry Creek School District Board of Education and was Board President from 2011-2013. She is a graduate of Miami University in Ohio.

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 


Jennifer Churchfield - CHAIN
Jennifer Churchfield - CHAIN

MARCH 9, 2023

Dear (Chair) and Members of the Health & Insurance Committee 

Thank you for the opportunity to provide this written testimony to the House Health & Insurance  Committee on HB23-1225, the PDAB Modernization Bill. 

In 2021, I was one of dozens of everyday Coloradans, doctors, hospitals, medical providers and other  stakeholders to testify in opposition to the original PDAB bill, SB21-175. 

The concerns raised then about embarking on an ill-advised and unproven program where the state  controls the price of prescription medicines lasted well into the night. Questions were never answered  on how the state would ensure that patients in Colorado would receive real, tangible savings on  prescription drugs, how the state would guarantee that patient access to life-saving medicines would  not be compromised, and how the PDAB law would not put our health providers in the horrific vice of  having either to deny patients the drugs they need or violate the law.  

Twenty months and over $1.6 million in taxpayer dollars, these questions remain. The PDAB has not  even brought up a single prescription drug for consideration of the upper payment limit (UPL), the  supposed silver bullet for how costs will be lowered. Instead of producing real results for struggling  Colorado drug consumers, the state had to go back for an additional $260,000 on top of the original  appropriation. 

Inexplicably, we are now looking at the introduction of HB23-1225 as a massive expansion of the PDAB  program and reach. The bill removes the two key guardrails put in Sb-175 that legislators agreed to as a  pledge to help ensure that, if nothing else, the potential damage of the PDAB program can be mitigated.  Instead, HB23-1225 gives PDAB “carte blanche” to set a UPL for any drug they choose, as opposed to the  twelve drug limit and doubles the sunset period from five to ten years. 

We should be going in the opposite direction. Before taking any more action or gaining more control,  the state legislature and the executive branch should be requiring that the PDAB board answer  questions about the cost/benefit being promised to Colorado patients: 

  • 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 possibly 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 the course of its five-year extension?

Unfortunately for Colorado patients, families and taxpayers, these questions only begin to tackle the  looming risks and costs posed by the PDAB concept. Add to those the fundamental violation of our free market system that having a government price-setting board represents, and the chance of a nightmare  scenario facing the state’s patients and taxpayers becomes all too real. 

I urge the state legislature to vote no on HB23-1225 and instead conduct a rigorous review of the  hazards and harms PDAB may pose to Coloradans and address ways to ensure patients already  struggling under high healthcare costs aren’t faced with further suffering.  

Thank you, 

Jennifer Churchfield

Supporting Long Overdue Colorado Healthcare Consumer Rights

Supporting Long Overdue Colorado Healthcare Consumer Rights

The year 2022 promises exciting and substantive opportunities to bring better health care to Coloradans.  Maybe the most important of these is the discussion around a Colorado Consumer Health Bill of Rights.  Similar initiatives have sprung up in other states, indicative of the need to put consumers front and center in the health care debate.  It is long past time that consumer needs take precedence over the financial interests of health care corporations.  We expect more to come very soon on this critical effort. 

Kavita V. Nair

Kavita V. Nair


“Coloradans continue to struggle to pay for their prescription medications. The largest yearly survey of Colorado households conducted by the Colorado Health Institute found that one in five Coloradans skipped health-care services due to cost concerns in 2021. Of the almost 10% of Coloradans who didn’t fill a prescription due to cost, 40% said their health declined.”

Read the full op-ed at:

Rep Iman Jodeh

St. Rep. Iman Jodeh (D-Arapahoe)


“Our bill is essentially a consumer protection bill, making common-sense reforms that will bring integrity and fairness to our health care system and save Coloradans taking expensive medications up to $1,000 a year. 

First, this bill will immediately reduce out-of-pocket prescription costs for Coloradans and prevent insurance companies from pocketing the billions of dollars in prescription drug rebates meant to help Colorado patients pay for their medicine”


Too little is being done in Colorado and across the country to put more power in the hands of consumers. Out of pocket costs and ‘skimpy coverage plans’ rob from consumers and oftentimes fail to deliver on the care people need.

The one positive piece of news from the challenges of the global pandemic is the transformative migration to digital health care. Practically overnight, consumers and providers discovered that many aspects of care can be delivered in totally different ways.

We need to take this disruption and convert it into a complete rethinking of how healthcare is provided that centers on the consumer, not the monied institutions that for too long have controlled healthcare policies.


According to a new poll, Americans would like to see Congress focus more on reducing the overall costs of health care coverage such as premiums, deductibles, and copays (71%) over reducing the costs of prescription drugs (29%). This extends across party lines; 73% of Democrats and 64% of Republicans would like to see Congress focus on reducing overall costs of coverage.

And it’s no wonder. According to various sources, total out of pocket costs for families in 2018 exceeded $7,500 per year. We all have to be wondering what the point of insurance is if we have to pay upwards of $8,000 before any coverage kicks in.

There are scores of ideas available for Colorado lawmakers to consider that don’t involve draconian measures like setting prices or capping revenues. CHAIN will continue fighting for ways to directly lower out-of-pocket expenses and clamp down on the kneejerk response of shifting costs to consumers by providers whenever changes in the market occur.

Ensure Federal Drug Program Serves Patients, Not Profits


Sprawling government health care programs can mean billions are wasted or misappopriated.  The 340-B program, a $29b effort to lower the cost of prescription drugs for those most in need, is a classic case.  The program has morphed into a source of profits for hospitals and other providers, taking billions in benefits away from low income and underserved families in need.  CHAIN is working toward restoring integrity to the 340-B program, and calling out similar government initiatives that have gone off course.  


Prescription Drugs: Spending, Use, and Prices

In recent years, policymakers have expressed concerns about the high prices of prescription drugs. Those drugs offer wide-ranging benefits, such as reducing the need for services provided by physicians and hospitals, improving the quality of life, and extending life. However, high prices reduce consumers’ access to such medications. They also contribute to higher spending that strains budgets, including the federal budget.



The 340B program is a classic case of good government intent can morph into abuse, and why we should exercise extreme caution with further government intervention.

According to the Pacific Research Institute:

By attempting to help vulnerable patient populations in such an overly complicated manner, the 340B program creates inefficiencies throughout the broader healthcare system… These include vulnerable patients not receiving any of the price savings, the abuse of the 340B program by covered entities, increased incentives to prescribe more expensive medicines, a shifting of drug costs on to non 340B patients, and an unwarr-anted consolidation of medical practices. Due to these inefficiencies, the 340B program worsens the quality of the overall health care system.

Instead of drug discounts flowing to those families most in need, the PRI report demonstrates how millions of dollars are likely flowing to the coffers of hospitals and other providers.


A report by the non-partisan Government Accountability Office (GAO) layout out the path for greater accountability.  The GAO found major gaps in the administration of the program and lax accounting/reporting standards.  They conclude their work with six strong recommendations for reforming how the 340B program operates, including audits that verify the proceeds from discounted drugs are being used to lower the cost to consumers in need. 


CHAIN fully supports Coloradans engaged in demanding greater accountability and transparency in the 340B program.  We urge everyone to look at 340B as the cautionary tale for why creating massive government programs to address health care inequities should be among the last strategies used.

Fight Policies That Endanger Access to Life Saving Medicines


Colorado doctors, patients, health care providers and experts are all expressing serious concerns about the impact a bill introduced in the state legislature this year will have on patients access to life-saving treatment. CO Senate Bill 175 threatens access to life-saving medicines by giving politicians control over what your doctor or hospital can pay for prescription drugs.  If the medicine costs more than what the state allows your doctor to pay, your doctor won’t buy the medicine, and you or your loved one won’t be able to get the treatment needed.

Those Most Vulnerable May Suffer the Most

Groups representing the disabled, LGBTQ, people of color, the underserved and Colorado’s seniors are speaking out in concern with SB175, especially the proposal that would let state politicians control prices and access to life-saving drugs.

Colorado small business owners and bioscience researchers are seriously worried about the impacts the bill will have on Colorado’s role as a leading medical research center.  And they are equally concerned about the gross interference in how life-saving medicines are priced and by extension how research happens.

Coloradans From All Walks of Life Speaking Out

This is just a partial list of the organizations speaking out against SB175’s provision to let state politicians control the cost and access to prescription drugs:

Colorado Society of Pharmacists
Colorado Retail Council
Colorado Gerontological Society
Adams County Regional Economic Partnership
The Citizens Council for Health Freedom
Colorado Sickle Cell Association
Colorado Council of Black Nurses
Front Range Pharmalogic
West Slope Pharmalogic
Jefferson County Economic Development Corporation
Club 20
Westminster Chamber
Envision: You (an organization that supports, educates and empowers members of Colorado’s LGBTQ + (mental health and well-being for the lesbian, gay, bisexual, transgender, and queer/questioning community)

You can read the specific concerns of many of these groups here:

The impact of Coloradans speaking against compromising care and treatment is being felt across our state.

These are a sample of recently published articles in newspapers throughout Colorado of people voicing concerns about not being able to access today’s life-saving medicines or seeing tomorrow’s cures be stopped in their tracks.

The impacts of Senate Bill 175 on our care are real.  But so is the impact of us speaking out.  Together we can stop SB175 from becoming law and cutting off our access to hures.

Mark Spiecker, STAQ Pharma: A state prescription drug board will backfire


Emily Zadvorny, Colorado Pharmacists Society: A state Prescription Drug Affordability board puts pharmacies, access to medication at risk

Jennifer Churchfield, Front Range PharmaLogic: State drug price limits would not drive down prescription prices

Rep. David Soper: Colorado Should Reject European-style price-setting board

Joni Inman, Front Range PharmaLogic: A prescription-drug price-control bill is the wrong answer for Colorado

Additional Resources

Opposition Testimony: CO SB 21-175 to establish a Prescription Drug Affordability Review Board

Senate Health and Human Services Committee, March 17, 2021

SB 21-175: Provider Testimony, Senate Health and Human Services Committee

Dr. Miller Head of Rocky Mountain Oncology Society, Chief Medical Director of Oncology; Associate Chief Medical Director of Clinical Research, SCL Health Cancer Center of Colorado

Governor and Legislature Drug Pricing Bill Harms Patients

“Prescription Drug Affordability (Price Control) Board” Means More Bureaucracy – Not Cheaper or more Accessible Medications for Patients


Get Involved

The Missing Colorado Healthcare Link

Linking the right policy ideas with the right influential people is a great start to solving our healthcare challenges. But it’s just the beginning.  

Fixing healthcare is our shared responsibility. And Colorado citizens like you are the missing link. With your trust and support, we can create lasting change.

We can solve healthcare in Colorado. Ready to link up with CHAIN?