Application for Prescription Drug Affordability Advisory Council

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Thank you for your interest in the Colorado Prescription Drug Affordability Advisory Council.

The Advisory Council is created in the Division of Insurance to provide stakeholder input to the Colorado Prescription Drug Affordability Review Board regarding the affordability of prescription drugs. The Advisory Council will include 15 members, 14 appointed by the Colorado Prescription Drug Affordability Review Board.

Email *

First and Last Name *

Contact Information (Email, Phone) *

Current job title (Title, Company) *

Please explain why you wish to serve on the Advisory Council. *

Please select the experience you bring to the Advisory Council (Select up to 2) *

I am a health care consumer or represent health care consumers

I represent a statewide health care consumer advocacy organization

I represent health care consumers who are living with chronic diseases

I represent a labor union

I represent employers

I represent health insurance carriers

I represent pharmacy benefit management firms

I represent health care professionals with prescribing authority

I am employed by an organization that performs research concerning prescription drugs, including pricing information

I represent manufacturers of brand-name drugs

I represent manufacturers of generic drugs

I represent pharmacists

I represent wholesalers

None of the above

Required

In which congressional district do you live? *

Colorado Congressional District 1 (Denver)

Colorado Congressional District 2 (Larimer, Grand, Boulder, Gilpin, Clear Creek, Summit, Jefferson, Eagle, Broomfield, Park)

Colorado Congressional District 3 (Western slope)

Colorado Congressional District 4 (Eastern slope)

Colorado Congressional District 5 (Chaffee, Fremont, El Paso, Teller, Park)

Colorado Congressional District 6 (Arapahoe, Adams, Douglas)

Colorado Congressional District 7 (Jefferson, Adams)

Unknown

Where do you have subject matter expertise?

Pharmaceutical business model

Supply chain business models

Practice of medicine or clinical training

Health care consumer or patient perspectives

Health care cost trends and drivers

Clinical and health services research

Colorado's health care marketplace

None of the above

If you answered "none of the above" to question 6, please explain the other subject expertise you bring to the Advisory Council?

SB21-175 requires the Board to appoint council members "who have experience serving underserved communities and reflect the diversity of the state with regard to race, ethnicity, immigration status, income, wealth, disability, age, gender identity, and geography". Please discuss how you meet these requirements.

Are you able to commit to a two year term? *

Yes

Unsure

A copy of your responses will be emailed to the address you provided.

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