Our partners at the All Copays Count Coalition recently organized an effort regarding the reintroduction of the “Help Ensure Lower Patient Copays Act” (HELP Copays Act). Over 70 patient advocacy organizations signed onto a joint letter pledging to work with members of Congress to ensure this proposed legislation becomes law.
Many cancer patients face complicated financial barriers when accessing lifesaving prescription medications that are necessary for treatment, and many depend on copay assistance programs to offset expensive drug prices.
If passed, the proposed bipartisan HELP Copays Act would require healthcare plans to count any funds patients receive from medication copay assistance programs to be counted towards their annually capped out-of-pocket expense amount, preserving the original intent of copay assistance programs.
The proposed HELP Copays Act would ultimately prohibit the use of “copay accumulator” models that both healthcare plans and pharmacy benefit managers sometimes use to pocket copay assistance funds received by patients by ensuring that any cost-sharing assistance received counts towards annual deductible minimums or out-of-pocket maximums.