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Accumulator adjustment programs target manufacturer copay assistance programs available for specialty drugs by no longer allowing them to count towards a member’s deductible or out-of-pocket responsibilities. For patients who depend on life saving medications that are high cost/high value (life and death), such as hemophilia, these programs absolutely threaten adherence, posing significant unintended consequences to patients and run the real risk of actually increasing the total cost of care for the purchasers of health care.
As a result, some states have implemented copay accumulator adjustment bans, with others expected to follow; and CMS has issued the NPBB final rule, beginning January 1, 2020, stating insurers may not implement these programs for specialty drugs which have no generics; and while they may implement the programs if there are generics, they can’t penalize patients if the generic is ineffective.
This webcast will outline the current landscape of copay accumulator programs with unique perspectives from our expert faculty presenters. The webcast is provided by the Comprehensive Care Sustainability Collaborative (CCSC). The aim of CCSC is to provide payers, purchasers, and other key stakeholders with knowledge and skills crucial for managing the high costs associated with hemophilia and other bleeding disorders.
Opening Comments
Kollet Koulianos, MBA
Copay Accumulator Program Overview
James Kenney, Jr., RPh, MBA
The Population Health and Well Being Impact of Pharmacy Benefit Designs
Tom Sondergeld, MHA
A Patient Advocacy Viewpoint of Accumulator Adjustment Programs
Kollet Koulianos, MBA
Audience Q&A
Faculty Panel