When Colorado defended its proposed price cap on Enbrel in federal court, it didn’t deny that someone would take a financial hit. It simply argued the hit didn’t have to land on the plaintiff in the case, the manufacturer.
On July 1, 2026, a federal judge blocked Colorado’s Prescription Drug Affordability Board from putting its price cap on Enbrel into effect. The proposed cap is the first of its kind anywhere in the country and was supposed to be implemented starting January 1, 2027. Now it’s on hold while the case against the state plays out.
The State’s Own Argument
In defending the state’s right to impose the price cap, Colorado didn’t argue that a mandated price cut comes for free. Instead, the state argued Amgen couldn’t prove the burden would land on Amgen at all. As the Colorado Sun reported, “the state’s attorneys argued that Amgen couldn’t show it would be harmed by the price cap, since it’s possible the hit would be absorbed by others along the supply chain, such as distributors or pharmacies.”
The judge didn’t buy it. As Reuters reported, he said it was, in his words, “basic economic logic” that the manufacturer would take a financial hit “even if the cap applies unevenly” across the supply chain.
A Feature, Not a Flaw
Whether the argument won in court matters less than what it tells us about how Colorado sees its own policy.
Colorado’s defense rested on a simple idea: the upper payment limit price cap doesn’t have to lower what it actually costs to make or move a drug. The UPL just has to lower what a purchaser – like the state – pays for the drug, while somebody else in the supply chain makes up the difference. That’s not unique to any specific drug; it’s baked into how every UPL works. Colorado is ambivalent about whether that somebody includes the pharmacies handing treatments to patients every day, including specialty pharmacies and the independent and rural pharmacies.
Looking further ahead, this could result in fewer local pharmacies and greater difficulty for patient access to their medications. In fact, surveys from the National Community Pharmacists Association show difficulty stocking and receiving reimbursement for drugs subjected to federal price controls as part of the Medicare Drug Price Negotiation Program.
Colorado never treated that tradeoff as a problem to fix. It treated it as a defense. If the cost lands on distributors and pharmacies instead of the drugmaker, the state argued, that doesn’t matter because they’re not the ones who sued.
That’s not a policy built to protect patients. Rather, pharmacy challenges with upper payment limits are a predictable outcome that advocates consistently highlighted to the state’s Prescription Drug Affordability Board as it deliberated whether to set one in the first place.
What Comes Next
This ruling pauses Colorado’s price cap; it doesn’t end it. The case continues, and the state’s drug board is already reviewing caps on two more drugs.
Other states chasing upper payment limits need to answer for what Colorado’s own attorneys just admitted in open court: these policies depend on somebody downstream quietly covering a shortfall the state never planned for.
Colorado’s defense acknowledged that negative impact on distributors and pharmacies. But it never acknowledged where that shortfall ultimately lands — with patients having trouble accessing their medication.