Copay accumulator full#

Here are highlights from MMIT’s March 2021 Copay Accumulators and Maximizers: Payer Management Approach survey performed for PhRMA. Co-pay accumulators could jeopardize outcomes, as patients may decide to forego or discontinue treatment or seek different treatment for non-medical reasons.

Copay accumulator full#

We commend the FTC for its leadership to investigate the impact that PBM practices have on the patient communities we serve and believe this represents a critical step forward to improving patient access and affordability to necessary medications. In a survey conducted by MMIT, 75 of insurers and middlemen surveyed believe that employers and other plan sponsors that decline accumulator adjustment programs do so because of concerns that the programs can negatively impact patients. Co-pay accumulator programs lack transparency and are often implemented without a patient’s knowledge or full understanding of their new benefit. While most people think insurers make the majority of decisions regarding health coverage and affordability, when it comes to prescription drugs, it is the PBMs that drive much of the decisions as to what medications a beneficiary can access and how much they pay for them. Specifically, we offer comments on how PBMs impact the health and well-being of patients who receive their health coverage through the private insurance market. We, the undersigned 105 organizations, on behalf of millions of patients and Americans who live with complex conditions such as HIV, autoimmune diseases, cancer, diabetes, kidney disease, lupus, hemophilia, mental illness, and hepatitis write in response to the Federal Trade Commission (FTC) request for public comment on the impact of pharmacy benefit manager (PBM) practices on consumers.