Copay Accumulator Programs Allowed In 2023 Private Insurance Market In Proposed Rule
Commercial payer programs to undercut manufacturer cost sharing assistance for drugs may continue next year under proposed rule released by the Centers for Medicare and Medicaid Services.
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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.
Lawsuit highlights the lack of transparency into pharmacy benefit manager activities and how their programs can influence drug pricing. A Senate hearing on PBMs held shows increasing momentum behind a Federal Trade Commission study on potential anti-competitive activity in the market sector.
The regulatory provisions being challenged are part of a Trump-era “midnight rule” that could be changed by the Biden Administration before implementation, but PhRMA is not taking any chances about the future of copay assistance programs.