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