To help patients access costly prescriptions, pharmaceutical manufacturers offer copayment assistance, like coupons, to greatly reduce patients’ out of pocket costs for their company’s medication. These copay assistance programs are being targeted by health plan programs through copay accumulator programs which use this financial assistance to collect more proceeds from patients.  

Under copay accumulator programs, the value manufacturers pay pharmacies for for a patient’s treatment does not count towards that patient’s deductible or out of pocket spending requirement. As result, the patient’s deductible is never met, and they are eventually caught off guard with by charges for the full price of their prescription when copay support no longer mitigates this cost 

ACR supports the Help Ensure Lower Patient (HELP) Copays Act, (H.R. 830/S. 1375), to require health plans to count the value of copay assistance toward a patient plan’s cost-sharing requirements. This would ensure that all payments, whether they come directly out of a patient’s pocket or from the help of copay assistance, count towards their out-of-pocket cost calculation under their healthcare plan. 

Act now to urge your lawmakers to protect patients from soaring out of pocket costs! The ACR’s Legislative Action Center will allow you to contact your members of Congress with just a few clicks. Take a moment to send your letter today!