On October 16, the Ohio Coalition for Affordable Prescriptions (OHCAP) hosted a meeting at the Ohio Pharmacists Association to share updates about co-pay accumulator policies and their negative impact on patients who use manufacturer coupons for prescription purchases only to find that their insurers and pharmacy benefit managers have implemented accumulator requirements that fail to apply purchases made with coupons to their deductible.
Many patients with rare diseases rely on copay cards and coupons from drug manufacturers to help pay for their prescription drugs. This assistance can help patients save thousands of dollars on their prescriptions each month. One of the major features of these cards is that their value (the savings) also applies to a patient’s insurance deductible and coinsurance. Because of this, patients can save money on their prescriptions and have an easier time meeting their other insurance plan costs.
Recently, several health insurers have instituted co-pay accumulator programs that prevent manufacturer co-pay cards from applying to a patient’s health insurance deductible and coinsurance. As a result, patients who depend on co-pay cards must now pay considerable more money out of pocket. Co-pay cards are often based on financial need and, in nearly all cases, exist to help patients pay for expensive, innovative therapies for which there are not generics on the market. Patients may suddenly receive an expensive bill before even realizing that their health plan was using an accumulator program.