The high costs of medical care are well-documented, but those battling significant illnesses have found a measure of economic relief through manufacturer cost-sharing assistance programs.
The programs are currently threatened by courses of action taken by the administration. It is seeking to use health plans to use accumulator adjustment programs to exclude the value of cost-sharing assistance from out-of-pocket maximums, PHRMA reported. The second threat is the Centers for Medicare and Medicaid proposed a rule that would make it a challenge for manufacturers to help patients in the commercial market. Both would take away discounts that prove beneficial to patients and save hundreds of dollars on a monthly basis.
PhRMA reported manufacturer cost-sharing patients who were afflicted with asthma/COPD, diabetes and depression saved $300 to $500 annually on average. The savings were more substantial for those with multiple sclerosis, HIV and cancer which turned into savings of $1,600 to $2,200.
Cost-sharing assistance has become en vogue because many who are chronically ill do not benefit from the large rebates pharmacy benefit managers and health plans negotiate with biopharmaceutical companies. Instead, they pay the full price of their medicine, PHRMA reported.
The trend of cost-sharing assistance has picked up steam, as IQVIA indicated hundreds of thousands of dollars have been saved. The are not only an important source for financial support, it helps lead to improved patient outcomes.
PhRMA reported that given 70% of chronically ill patients considered in the report that benefit from manufacturer cost-sharing assistance, the administration should refocus its efforts on prioritizing solutions to improve affordability for those patients who are not threatened. It suggested that policies such as lower patient cost-sharing, reform the rebate system and work toward making plans to count cost-sharing assistance toward out of pocket limits in an effort to make insurance work like insurance.
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