As more insurers and employers use a new tool called copay accumulators to fend off copay assistance from drug makers, the pharmaceutical industry is fighting back with an analysis that suggests employers should think twice because they may be at risk for doing so.
Copay accumulators have been embraced over the past year by a growing number of insurers and employers in hopes of limiting prescription drug spending. The reason is that accumulators do not count the value of any copay assistance cards or coupons — which drug makers often readily provide — toward out-of-pocket medicine costs that are applied toward deductibles.
As a result, accumulators have grown controversial. The key reason is consumers are being asked to fork over more money, especially since accumulators target specialty medicines that are often injected or infused — and typically, are more expensive. Last year, 17 percent of employers used accumulators and 58 percent were considering doing so, according to the National Business Group on Health, a nonprofit.