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WASHINGTON — Insurers will have to count drug copay coupons toward deductibles and patient spending caps in most cases, after a Biden move in federal court on Tuesday.
Drug companies use copay coupons to help patients cover the cost of their drugs.
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Before now, when drug companies helped patients pay their share of drug costs, insurers often didn’t count that assistance toward deductibles and out-of-pocket limits. In insurance jargon, this tactic is called a copay accumulator. Previously, the practice was only allowed when drug companies give coinsurance assistance for brand drugs with generic competition. The Trump administration let insurers use the tactic when cheaper generics were not available.
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