HIV+Hep’s Carl Schmid’s presentation before the NAIC Regulatory Framework Task Force on the value of copay assistance for Rx, state laws that ensure copay assistance counts, and ways to mitigate any potential conflicts with those state laws with IRS/Health Savings Account issues.
Details the harmful impacts copay accumulators have on drug adherence and patients costs, federal and state actions taken to date to ensure copay assistance counts, and advocacy opportunities at the federal and state levels patient groups can engage in relative to copay accumulators.
Examines how insurance benefit design, including high deductibles and co-insurance, impact prescription drug access, along with the importance of copay assistance and how states are ensuring that it count towards beneficiary cost-sharing obligations.
Provides details on how insurers’ treatment of manufacturer copay assistance affects patients’ out-of-pocket spending and how high costs drive up prescription abandonment rates, especially while patients deal with the economic effects of COVID.
Provides an update on the growing practice by insurance company and PBMs that do not count copay assistance for prescription drugs towards a beneficiary’s deductible and out-of-pocket spending limits. Discusses the impact on patients and what it is being done at the state and federal levels to stop this practice.