2. Pharmacy sticker shock is here
Back in February, we highlighted how more consumers who use drug copay coupons are likely to be surprised with higher costs this summer when they pick up their prescriptions.
Well, it's happening. Employers, health insurers and pharmacy benefit managers started using "copay accumulator" programs that don't count the value of drug copay coupons toward a person's out-of-pocket costs, and people are starting to feel shock at the pharmacy counter.
- "It's putting a greater burden on patients bearing the cost of their drugs, and it's really impacting adherence to medications," said Carl Schmid, deputy executive director of The AIDS Institute, a patient group that receives drug industry funding.
- Schmid said his organization has heard from several people living with HIV who were not aware of the changes to their plans and thought they had reached their deductibles.
But, but, but: It's worth reminding that Medicare and Medicaid classify drug copay coupons as illegal kickbacks since they steer patients toward specific drugs and provide incentives for manufacturers to raise prices at will. Yet, discount cards are kosher in commercial health plans.
Go deeper: PepsiCo and Walmart are not counting drug copay coupons toward their employees' deductibles and out-of-pocket maximums this year.