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.
You may also be interested in...
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.'
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.
OIG will focus on successful drugs that have been repurposed as orphans, noting nine of the 10 top selling drugs have both orphan and non-orphan indications.