PhRMA President and CEO Stephen Ubl

PhRMA's court win over HHS could be a boon for phar­ma pa­tient as­sis­tance pro­grams

As out-of-pock­et costs have risen for pa­tients in the US in re­cent years, phar­ma man­u­fac­tur­ers have of­fered fi­nan­cial as­sis­tance — in­clud­ing to those with com­mer­cial in­sur­ance — to bet­ter shoul­der these high­er costs.

Catch­ing on to the ex­tent of this fi­nan­cial as­sis­tance, com­mer­cial health in­sur­ers have sought to pock­et at least some of that ex­tra mon­ey, de­vis­ing com­plex schemes known as “ac­cu­mu­la­tor ad­just­ment pro­grams,” that ba­si­cal­ly carve out this phar­ma as­sis­tance when cal­cu­lat­ing an in­sured per­son’s an­nu­al de­ductible and co­pay­ment for a drug.

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