One small policy change could make a world of difference to people living with medical conditions who struggle to afford high copays on medication.
Patients with hemophilia, cancer, autoimmune diseases, and other medical conditions often rely on copay assistance programs in the form of coupons and vouchers to afford their prescription medications.
But more frequently, health insurance companies are instituting policies that don’t count the value of copay assistance toward a patient’s out-of-pocket cost responsibility. Sometimes referred to as a “copay accumulator adjustment program,” these policies leave many unable to afford their medications and allow health insurers to double their profits at the expense of patients.
According to a National Hemophilia Foundation (NHF) survey, 86 percent of registered voters across political parties believe the government should require copay assistance to be applied to a patient’s out-of-pocket costs. Several states — including Georgia, Illinois, and Virginia — have taken action to ensure health plans count the value of copay assistance, but federal policymakers must take action to prohibit these policies and protect patients from rising out-of-pocket prescription drug costs.