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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CMS ‘Safe Harbor’ For Use Of Copay Accumulators In Private Insurance Challenged In Court
Patient groups ‘left with no choice’ but to challenge federal regulation allowing commercial payers to bar manufacturer assistance with drug costs from being counted toward deductibles and out-of-pocket spending caps.
Copay Accumulator-Type Programs Proposed For ACA Exchange Plans
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.
PhRMA’s Defensive Move On DTC Ads: Putting Drug List Prices ‘In Context’
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.