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An Upcoming White House Decision May Jeopardize Americans’ Access to Life-Saving Drugs

Summary:
I have been picking up more healthcare commentary which depicts the difficulty in providing healthcare at a sustainable cost. This brief commentary depicts one of the problematic issues for people. I believe this sentence makes the issue very clear. Copay accumulators are programs health plans use to prevent copay assistance from counting toward patients’ deductibles or out-of-pocket maximums. They do not count towards a deductible which the patient is still left with once the copay accumulator is maxed. An Upcoming White House Decision May Jeopardize Americans’ Access to Life-Saving Drugs By Katie Adams MedCity News The rule concerns the use of“copay accumulators.” Copay accumulators are programs health plans use to prevent copay

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I have been picking up more healthcare commentary which depicts the difficulty in providing healthcare at a sustainable cost. This brief commentary depicts one of the problematic issues for people. I believe this sentence makes the issue very clear. Copay accumulators are programs health plans use to prevent copay assistance from counting toward patients’ deductibles or out-of-pocket maximums. They do not count towards a deductible which the patient is still left with once the copay accumulator is maxed.

An Upcoming White House Decision May Jeopardize Americans’ Access to Life-Saving Drugs

By Katie Adams

The rule concerns the use of“copay accumulators.” Copay accumulators are programs health plans use to prevent copay assistance from counting toward patients’ deductibles or out-of-pocket maximums.

Typically, when patients receive copay assistance from pharmaceutical companies, the amount paid by the manufacturer helps reduce the patient’s out-of-pocket costs. But with copay accumulators, the assistance from the drugmaker is not counted toward the patient’s maximum limit on out-of-pocket expenses.

The White House could soon finalize a rule that will either save or cost patients billions of dollars in prescription drug costs.

“Once the copay assistance runs out, the patient goes to pick up their drug and they are slapped with a several thousand-dollar bill.  This is a surprise to them as they thought they were picking up their drug with no problem. They later learn that the copay assistance the insurer was collecting was not counting towards their deductible. In order to pick up their drug, they need to come up with the funds.”

This usually forces patients to make the decision of either going into significant debt or skipping their medication, Schmid noted.

He also pointed out that about half of all employer plans use copay accumulators or similar schemes — adding that these programs took nearly $5 billion in assistance away from patients last year. Schmid . . .

“We don’t understand why [insurers] are instituting these harmful schemes. We understand they are concerned about the high cost of drugs and they are trying to milk the drug companies, but at the same time they are harming patients.”

He said it’s unclear when the White House is expected to reach a decision on the rule, noting that it could be “any day now or several weeks.”

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