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Policymakers must protect copay assistance programs

For many patients, cost has become a barrier to obtaining the care and treatments they need to manage their chronic conditions. For medications specifically, patients often face high deductibles and steep cost sharing at the pharmacy counter.

Many patients find relief from these costs through copay assistance or rebate programs provided by drug manufacturers. Patients, doctors, and pharmacists can identify programs that apply to the medications prescribed and utilize them to lower the amount the patient is required to pay for that medication. The copay assistance applies after insurance, much like a coupon, and often lowers out-of-pocket costs for patients significantly.

These copay assistance programs are currently heavily relied upon by patients with chronic disease. They enable many patients to access their medications at prices that are manageable and within their current budgets. Therefore, changes to these copay assistance programs, would have an immediate and significant impact on the ways that patients pay for their medications.

In the past few years, copay assistance programs have received increasing attention from policymakers and changes to these programs have even been included in recent regulatory rulemakings. While each of these policies should be evaluated on their own merits, it is vital that current copay assistance programs that patients, especially those with chronic conditions/disease, rely upon are not upended or discontinued before a replacement structure or other assistance is in place.

Were these programs to be eliminated, patients would face a significant increase in costs to access the medications they currently rely upon. This would have an undue impact on patients with chronic conditions that likely rely on one or more medications to manage their health. These changes could increase their health costs significantly and even prevent them from accessing the treatments they need.

Instead, we encourage policymakers to work directly with CCPA and other patient advocates to understand the impact immediate changes in policies around copay assistance programs would have on patients and come up with ways to phase in new policies and ensure patients have the assistance and safety net required to maintain their care.