he growing use of copay accumulators — a new weapon against widely used but controversial copay assistance cards that drug makers distribute to consumers — is causing average net prices for medicines to fall, according to a new analysis.

In the first quarter of 2018, net prices after concessions made by drug makers declined 5.6 percent, compared with a 1.7 percent drop in the corresponding quarter a year ago. This occurred even though increases in average wholesale — or list — prices more or less held steady at 6.2 percent versus 6.8 percent in the first quarter of 2017, according to Sector & Sovereign Research, which tracks the pharmaceutical industry.

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