When Copay Assistance Backfires on Patients

In early 2019, Jennifer Hepworth and her husband were surprised by a bill of $3,500 for their daughter’s cystic fibrosis medication, which had previously cost $30. This increase was due to a change in their health insurance plan that no longer counted copay assistance towards their deductible. This practice, known as copay accumulator programs, allows insurers to save money by capturing funds from drugmakers instead of patients. Patient advocacy groups are against these programs, citing the financial burden they place on patients. Legislation has been proposed to require copay assistance to count towards deductibles. Insurers argue that these programs help keep premiums affordable.

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