STAT+: Biden defends Trump-era drug pricing rule on copay accumulators
Biden and Trump are on the same page when it comes to letting insurers not count drug company financial assistance toward cost sharing.
WASHINGTON — The Biden administration is appealing a court ruling against a Trump-era regulation that aimed to protect the way health insurance companies handle some prescription drug costs — a rare moment of harmony between the two administration’s approaches to drug pricing reform.
At issue is a health insurance industry practice of not counting drug company coinsurance assistance toward a patient’s out-of-pocket costs. Health plans use tools, called copay accumulators, to keep tabs on whether patients or drug companies were paying the tab for a certain medicine — and don’t count any drug company assistance toward a patient’s deductible or plan maximum.
Insurers say they’re trying to control drug prices. When a drug company pays a patient’s share of a drug’s price, it’s easier to maintain a high price because patients stop caring about it. Medicare bans drug company coinsurance assistance on similar reasoning.
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