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Even as prescription drug costs remain an important pocketbook issue for many Americans, the Trump administration has taken a new step that will likely raise expenses for many patients, a move that consumer advocates find upsetting and puzzling.

As part of a final rule setting standards for health benefits, the Centers for Medicare and Medicaid will allow private insurers and employers to exclude certain copay assistance programs, such as cards and coupons provided by drug makers, from counting toward deductibles and out-of-pocket maximums. The decision applies even when there is no generic alternative to a pricey, brand-name drug.

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