Copay Accumulator and Maximizer Update: Adoption Plateaus as Insurers Battle Patients Over Copay Support
Excerpt from Drug Channels
Is the gold rush in copay accumulators and maximizers slowing down?
Our latest update finds that for 2022, about 40% of commercial lives have adopted these benefit designs. Accumulator adoption has plateaued, while maximizer use has overtaken accumulators. Patients who take a single-source, brand-name specialty drug for autoimmune conditions, multiple sclerosis, and oncology increasingly face these benefit designs. Check out the plan and patient data below.
Patients are caught in the middle of a complex battle among insurers, PBMs, and drugmakers. They are rightfully unhappy that their plans are grabbing the copay support funds. That’s why legislation, lawsuits, and patient advocacy are growing. Manufacturers are also pushing back on plans’ copay games.