Over the past 10 days, Virginia and West Virginia became the first states in the U.S. to adopt laws that preclude certain health plans from using copay accumulators, a new weapon against widely used but controversial copay assistance cards that drug makers distribute to consumers.
The laws, which cover individual and small market plans, come as a growing number of health plans and employers embrace accumulators to blunt rising drug costs. About 30% of employers have adopted them and another 21% are considering doing so over the next couple of years, according to the National Business Group on Health, a nonprofit. Wal-Mart and Home Depot are recent examples.
Why? For years, drug makers have distributed copay assistance to patients who need help paying for medicines in order to boost sales. But accumulators do not count cards or coupons toward out-of-pocket costs that are applied toward deductibles. So after a card or coupon is used up, a patient must cover the full copay cost themselves, get a new card or coupon, or stop filling the prescription.