Accumulator Adjustment Programs (AAPs)

Accumulator Adjustment Programs (AAPs)

What are they?

What are they? Accumulator Adjustment Programs (AAPs) are tools utilized by insurers and pharmacy benefit managers (PBMs) to exclude co-pay assistance as an out-of-pocket expense. This, in turn, excludes co-pay assistance from being applied to a patient’s deductible.

What this means for patients:

For patients with complex, chronic conditions, co-pay assistance is vital. Typically, it offers these patients access to their necessary medical therapies at a reasonable rate, however when it is excluded as an out-of-pocket expense, cost of care skyrockets. Patients are then left to choose between two options: endure outrageously high medical costs, or discontinue their successful treatment, leading to adverse health effects.

FSR Policy:

Nothing is more important to our organization than a patient’s health. That is why co-pay assistance should count towards the deductibles of patients with chronic conditions. We also emphasize that insurers have a responsibility to notify patients of any existing AAPs.