Copay assistance

Biden administration begins to address patient affordability of medications: but fails to ensure copay assistance counts as patient cost-sharing

The Biden administration released a proposed rule that will govern how private health plans must operate in 2023 and in doing so, took some steps to limit patient cost-sharing for prescription drugs. However, despite the urging from patient groups, they are not requiring insurers and pharmacy benefit managers (PBMs) to count copay assistance towards patient out-of-pocket cost-sharing and deductibles.

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Biden administration passes on protecting patient affordability of medications

“We are deeply disappointed that CMS passed on addressing the issue of copay assistance for prescription drugs and requiring insurers and pharmacy benefit managers (PBMs) to count assistance towards patient out-of-pocket cost-sharing and deductibles,” commented Carl Schmid, executive director of the HIV+Hepatitis Policy Institute.

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