Financial Assistance vs. Copay Accumulators: Patient Cost Protection

High out-of-pocket costs push many adults to skip ⁢doses of their medication, split tablets, or abandon new prescriptions. Cost ‌conversations frequently enough start with pharmacists at⁢ the counter or in the clinic.

In a systematic review published in​ the Journal‍ of Managed care and Specialty pharmacy, researchers analyzed financial medication‌ assistance including manufacturer patient assistance programs (PAPs), copay cards, vouchers, discount cards, and pharmacy programs ⁣that help patients apply.¹ Pharmaceutical drug manufacturers create these ​programs to‍ help patients afford their medications. The review included⁤ 8 observational ‍studies in cardiovascular disease and⁤ oncology.

Financial medication assistance consistently improved medication adherence and persistence over approximately 1 year or less.¹ Patients who received assistance achieved ⁢higher medication possession ratios, 7% to 18%⁣ higher than patients without assistance. ⁤Fewer patients stopped therapy when they received assistance, with discontinuation approximately 7% lower in cardiovascular studies. Clinical outcomes were positive ‌or⁤ null, although some ⁢patients had higher out-of-pocket spending due to staying on high-cost medicines.¹

A primer in the same journal describes copay accumulators, copay maximizers, and alternative‍ funding programs-increasingly used by insurers and self-insured employees as part of their plan’s ‍pharmacy benefit design. These progr