Patients today are being asked to pay a significant share of prescription costs for more-expensive specialty drugs, because of high co-insurance amounts. Many patients also face a deductible for their prescriptions. For the 2018 benefit plan year, however, many plan sponsors are adopting a copay accumulator approach that alters the conventional scenario. Accumulator programs target specialty drugs for which a manufacturer provides co-payment assistance. Unlike conventional benefit designs, the manufacturer’s payments no longer count toward a patient’s deductible or out-of-pocket maximum.
- Examine top reasons copay accumulators were put into place and the intended benefits of the program
- Explore the copay accumulator impact on the patient and what it means for patients out of pocket costs
- Discuss different ways manufacturers can provide assistance to ensure patients can still access and afford their therapies
- Examine different ways to evaluate the impact of copay accumulator programs on patients, manufacturers and hub service providers
- Learn about a broad range of solutions that can help address the needs of patients and manufacturers impacted by accumulator programs
- Discuss how to build a tailored approach and plan to address your unique situation
Director, Product Experience
The use of analytics while initiating, setting and utilizing a copay program can substantially improve the likelihood that the program will be successful. From analyzing the offer, to ensuring your targeting the correct prescribers, there are many factors that can catapult a program to greater levels of success. Dive into data analytics and develop skills to optimize patient support through leveraging data resources.
- Examine the unique utilization of analytics around prescriber usage and the dynamics of your patients to enhance success
- Explore optimal timing for program assessment and program optimization
- Address challenges within the evolving managed care landscape through data analytics
When discussing the use of copay card and assistance programs, many States are examining the impact on healthcare costs and benefits. While a majority of states have been unsuccessful in their quest to implement state regulations on copay cards, the success in California is causing a stir amongst manufacturers unsure what this means for the future. California State Assembly member Jim Wood introduced legislation that would ban the use of copay coupons in cases when an inexpensive generic would suffice. It is imperative for manufacturers to examine the thought processes behind such actions to ensure a deep understanding of the landscape and prepare program starteiges for the future.
- Examine the California copay card legislation and the impact this could have on future state-level regulation
- Assess drug transparency bills that are starting to show up in other states to truly understand the individual state landscape
- Discuss access issues around the Market Place Insurance Act and the effect on patient assistance and copay programs
Specialty Pharmacy Service Operations Manager
Assistant Vice President, Strategy, Business and Program Development
Carolina’s Healthcare System
- Evaluate the specialty market around limited distribution contracts with hubs and specialty pharmacies to understand top initiatives for each group
- Navigate compliance in reimbursement support services working with patient assistance programs and appeals
- Analyze the impact of pricing pressures on the specialty marketplace and how copay cards can fit into the design while ensuring compliance
- Examine the specialty market and the top concerns facing the industry with specialty pharmacies, providers, and copay utilization to reduce anti-kickback risks
Arent Fox LLP
Pharma and Biotech companies need to be able to offer assistance programs with the high cost of drugs. Co-pay programs, free drug programs and working with payers to ensure collaboration ensures patients have access to therapies and the help they need. Through examination of operational strategies best practices around copay design and the use of free drug programs, manufacturers can look to build prescriber relationships, and improve patient adherence to increase ROI.
- Examine ways to create structure and review committees around copay assistance and free drug programs
- Explore conversion data and analysis to assess how many patients transfer to paid patients and the timeline around program qualification
- Discuss the future of copay strategies, and if manufacturers will continue to utilize them
- Examine the evolution of the assistance model and ways to evolve to remain significant in the changing healthcare landscape
Blue Fin Group
In such an unsure time for the future of copay and coupon utilization, this session will give manufacturers the opportunity to come together and discuss the critical updates evaluated throughout the day. Allowing for an opportunity to ask questions, discuss best practices, and develop key strategies to implement within their organization.
- Examine changing pharmacy processes and the impact on patient access
- Discuss the implications of copay and coupon use with Part D
- Explore strategies to optimize copay cards with digital disruption