Drugmakers try evasion, tougher negotiations to fight new U.S. insurer tactic - (U.S. News & World Report via NewsPoints Desk)

  • Drugmakers are trying evasion and tougher negotiations to fight a new US insurer tactic, which forces drug companies to pay more to assist patients with their copays, as reported U.S. News & World Report Thursday.

  • This year, Express Scripts and others introduced a new "copay accumulator" approach, which prevents copay card funds from counting toward a patient's required out-of-pocket spending before insurance pay out on expensive specialty drugs.

  • Matthew Turner, who is working with drugmakers as director of patient affordability at TrialCard, which operates copay cards for companies, said drugmakers are working on ways to counter copay accumulator programmes, including the introduction of new payment options to evade detection by the pharmacy benefits managers so that a patient still benefits from the financial aid.

  • According to insurance industry executives and pharmaceutical consultants, drugmakers are also taking a tougher stance when negotiating prices or new discounts for payers.

  • While Amgen said previously that it altered copay assistance cards for its arthritis drug Enbrel to work only if the funds are applied to a patient's deductible, AbbVie said in April that around 4 percent of patients taking arthritis drug Humira were exposed to accumulators, which had no material effect on company profits.

  • Meanwhile, UCB said in February that it was reaching out to patients affected by the programmes to help them stay on the medication.

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