Discusses how Pharmacy Benefits Managers impact drug formulary decisions, patient cost sharing, utilization management, and pharmacy access.
Impact of PBM practices on patients
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Patient Community Perspective
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.
Searching for savings: An innovative approach to pay for prescriptions
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.
Ensuring patients can afford their medications during COVID-19
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.
Copay accumulators: Increasing patient costs for prescription drugs
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.