State Board of Pharmacy: Prescription Affordability Programs

State Board of Pharmacy Prescription Affordability Programs

Insulin Affordability Program

Individuals can receive a 30-day supply of prescription insulin for no more than a $50 copay They are also eligible for an emergency 30-day supply of insulin once per 12-month period for no more than a $35 copay.

Insulin Affordability Program Emergency and 12-Month Insulin Supply Application - English
Insulin Affordability Program Emergency and 12-Month Insulin Supply Applications - Spanish

The Insulin Affordability Program was created by HB21-1307. Minor updates were made to this law via HB24-1438.

Who Qualifies for the Insulin Affordability Program?

To be eligible for this program you must:

Be a resident of Colorado
Have a current prescription for insulin
Pay more than $100 for a 30-day supply of insulin
Present identification proving Colorado residency including, but not limited to, a valid Colorado identification card, driver's license or permit, or tribal-issued identification. If you are a minor under the age of 18, your parent or legal guardian must provide proof of residency.

Who Qualifies for an Emergency 30-Day Supply of Insulin?

If you are seeking an emergency 30-day supply of insulin, you must:

Have an emergency need for insulin
Have less than a 7-day supply of insulin available

If you qualify for an emergency supply of insulin, you may pay a $35 copay to receive a 30-day supply. You can only access an emergency supply of insulin once in a 12-month period.

Who Qualifies for an Affordable 12-Month Supply of Insulin?

If you are seeking an affordable 12-month supply of insulin:

You cannot be enrolled in or eligible for Colorado Medicaid (also known as Health First Colorado)
You cannot be enrolled in or eligible for Medicare

If you qualify for a 12-month supply of insulin, you may pay a $50 copay for each 30-day supply.

Manufacturer Patient Assistance Programs

You may qualify for a manufacturer's patient assistance program. Information on manufacturer's patient assistance programs:

Eli Lilly and Company

Novo Nordisk

Patient Assistance Program

Sanof

MannKind Corporation

Manufacturer Coupon Programs

Epinephrine Auto-Injector Affordability Program

Eligible individuals can receive an Epinephrine Auto-Injector for no more than a $60 copay. The Epinephrine Auto-Injector Affordability Program was created by House Bill 23-1002 and further updated by HB24-1438.

Coverage by Colorado-Regulated Health Coverage Plans

All Colorado-regulated health coverage plans that cover Epinephrine Auto-Injectors (including Affordable Care Act (ACA)-Compliant Health Benefit Plans and High Deductible Health Plans that include a Health Savings Account) must cap the copay at no more than $60.
You will be able to tell if you have a Colorado-regulated health plan if somewhere on your insurance card you see "CO-DOI," which means it is regulated by the Colorado Division of Insurance.
This is not to be confused with the Epinephrine Auto-Injector Affordability Program also established by this legislation and described above.

If you think your insurer is not complying with this requirement, please contact the DOI Consumer Services program at 303-894-7490 or dora_insurance@state.co.us.

Coverage by the Epinephrine Auto-Injector Affordability Program

Eligibility Requirements:

Be a resident of Colorado
NOT be enrolled in a Colorado-regulated health coverage plan that covers Epinephrine Auto-Injectors and caps the copay at $60.
- How to tell if you have a Colorado-regulated health plan? Somewhere on your insurance card you will see "CO-DOI," which means it is regulated by the Colorado Division of Insurance. If that is not printed on your card, your plan is NOT a Colorado-regulated plan.
NOT be eligible for or enrolled in Health First Colorado (Colorado Medicaid) or Medicare
Have a valid Epinephrine Auto-Injector prescription
Pay more than $60 for a 2-pack of Epinephrine Auto-Injectors, regardless of the amount or type of Epinephrine Auto-Injector

If you qualify for the Epinephrine Auto-Injector affordability program, you may be required to pay a $60 co-pay for each 2-pack of Epinephrine Auto-Injectors. An individual who is eligible to receive Epinephrine Auto-Injectors through the program may receive Epinephrine Auto-Injectors as prescribed for 12 months.

Epinephrine Auto-Injector Affordability Program Application - English
Epinephrine Auto-Injector Affordability Program Application - Spanish

If you have difficulty accessing this program, visit the consumer protection site of the Colorado Attorney General's Office (stopfraudcolorado.gov)

Manufacturer Assistance Programs

Regardless of your insurance status, you may qualify for a manufacturer's patient assistance program.

Viatris - State Epinephrine Auto-Injector Program

Viatris established a financial assistance portal for Colorado pharmacists to access in order to be reimbursed for dispensing a Viatris epinephrine auto-injector prescription to an eligible patient. CO pharmacists can access Viatris’ CO EAI Affordability Program Portal here.
As a reminder, Viatris continues to offer its traditional co-pay assistance programs for commercially-insured, eligible patients. These programs - which are separate and distinct from the CO EAI Affordability Program - may provide savings to CO patients and often reduce the out-of-pocket expense for patients below the $60 CO EAI Affordability Program amount. CO pharmacists can access Viatris’ Co-Pay Programs here.
Additionally, Viatris continues to offer epinephrine auto-injector products free of charge to eligible patients through its patient assistance program. CO pharmacists can access the Viatris' PAP program here.

Teva Colorado Epinephrine Auto-Injector Affordability Program

Visit this link to Download the Request Form
Eligible residents of Colorado can receive Epinephrine Auto-Injectors for no more than a $60 copay for each 2-pack of Epinephrine Auto-Injectors.

For Pharmacists: To receive your replacement Epinephrine Auto-Injectors, please complete the Request Form and return it to Teva Customer Service by fax (800-760-1009) or email to TevaCS@tevapharm.com.

Kaleo Auvi-Q Colorado HB23-1002 Patient Assistance Program

If you are a pharmacist dispensing product for Colorado HB 23-1002 and need assistance, please send an email to customersupport@kaleo.com.
Download the Kaleo Auvi-Q Form on the company website.

Amneal - Colorado Epinephrine Auto-Injector Affordability Program

For Pharmacists: To receive your replacement epinephrine auto-injector(s), provide the following information to Amneal Customer Relations via email to CustomerRelations@amneal.com. Please provide the following information.

Pharmacy DEA #
Pharmacy wholesale license #
Quantity of packs dispensed
NDC of dispensed product
Where the pharmacy purchased the product
Date product was purchased
Pharmacy name
- Street Address
- City
- State
- Zip Code

Please provide all requested information. Incomplete requests will not be processed.
If you have any further questions, contact Amneal by phone at: 877-835-5472 option 3 or email: drugsafety@amneal.com.

For more information on manufacturer patient assistance programs, visit foodallergy.org

Epinephrine Auto-Injector Affordability Program Applications

English

Spanish

Additional Processing Information for Pharmacies

For full statutory responsibility between pharmacies and manufactures please see the details in statute and/or specifically in HB23-1002.
Please see the manufacturer and resource links located on this page for billing information in addition to the required record keeping of the form.
Beyond the information provided in statute and on this resource page, you may contact your organization’s leadership for clarifications on internal billing or transaction processes with manufacturers.

Visit the Consumer Protection site of the Colorado Attorney General's Office at stopfraudcolorado.gov for assistance with a complaint.