(EDU-L6) Copay Accumulator and Maximizer Programs: Viewpoints, Controversies, and Consequences

Copay accumulator adjustment programs first appeared several years ago in response to drug manufacturer copay assistance programs that are designed to facilitate access to prescription drugs by offsetting required out-of-pocket cost-sharing responsibilities. Copay maximizer programs have appeared more recently to ensure that patients remain responsible for their financial obligations under their plan, while maximizing available manufacturer copay assistance dollars and keeping patient out-of-pocket contributions consistent throughout the benefit year.

Today, many payers have implemented these programs to help combat rising drug spend. However, these programs are controversial and are often criticized for their lack of transparency.

This session will review copay accumulator and maximizer programs, viewpoints of key stakeholders and potential consequences of regulatory and legislative involvement.