Payers' Latest Attack On Copay Coupons: 'Accumulator' Programs
More payers are implementing programs that block manufacturer copay coupons for specialty drugs from being applied to deductibles and out-of-pocket maximums, exposing members to higher drug costs.
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Annual payment rule for individual and group plans governed by Affordable Care Act proposes excluding drug manufacturer-sponsored copay assistance from out-of-pocket caps and seeks comments on use of reference pricing.
Member companies’ direct-to-consumer TV ads will direct patients to information about drug costs – including list price, estimated out-of-pocket costs for the drug, and availability of financial assistance – under a voluntary program that takes effect in April 2019; initiative falls short of mandatory list price disclosures proposed by Trump Administration.
Payer efforts to undercut copay assistance are getting manufacturers’ attention. PhRMA launches ad campaign warning patients that 'middlemen' are 'trying to keep you from reaching your deductible.'