![]() Far from working to lower the price of drugs, co-pay coupons for brand-name drugs are profit maximizers for drug manufacturers that raise health care costs (and thus health coverage premiums) for everyone, including the patients who are ostensibly helped. “No one should need a coupon to afford a life-saving drug. But unlike premiums, those underlying costs-and especially the brand-name prescription drug prices that are the primary driver of such costs-are wholly unconstrained.”Ĭopay Coupons Distort the Market for Big Pharma Profits “The bottom line is that health insurance providers work hard within this regulated system to keep premiums and out-of-pocket costs as low as possible given the underlying medical costs, and to give consumers a full range of plan options that carefully balance premiums against anticipated cost-sharing. … When increases in drug price drive up health care costs, some mix of premiums, deductibles, and cost-sharing for silver plans must go up, too.” “High drug prices are … directly correlated to higher deductibles and cost-sharing requirements deductibles do not go up simply due to health insurance provider pricing decisions. And while health insurance providers are strictly regulated to both cover costs and pass on savings, prescription drug prices are left wholly unconstrained based on unilateral price setting by drug manufacturers.” Ever-higher drug prices, in turn, necessarily lead to higher insurance premiums and cost-sharing amounts that impact hardworking American families. “Americans pay the highest prices in the world for medications, by a large margin, and the problem gets worse every year. In fact, co-pay coupons are so problematic that the federal government considers them an illegal kickback in federal programs like Medicare and Medicaid.” Substantial research, and AHIP’s members’ experience, show that unbounded drug manufacturer co-pay coupons are part of the problem-not the solution-to out-of-control drug prices. ![]() ![]() AHIP is committed to practical solutions that reduce consumer costs and increase patient access to needed medication. Escalating drug prices are a leading driver of rising health care costs, and they are an increasing financial burden for hardworking American families. “AHIP recognizes that many Americans struggle to afford prescription drugs. AHIP’s brief provides context that demonstrates both the reasonableness and importance of the accumulator rule. ![]() AHIP supports HHS’s defense of its copay coupon accumulator rule, which allows health insurance providers to determine whether to count direct financial assistance from drug manufacturers toward a patient’s annual cost-sharing limitation. District Court for the District of Columbia. United States Department of Health and Human Services (HHS), which is before the U.S. – (March 23, 2023) – AHIP filed an amicus brief today in HIV and Hepatitis Policy Institute v. Patients continue to benefit from copay coupons, while accumulators mitigate market distortion created to drive up Big Pharma profits ![]()
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