TapInto Phillipsburg: Ensuring NJ Patients Benefit from Co-pay Assistance Programs

By Jeanette Hoffman, Patients Come First New Jersey’s Executive Director

Dear Editor:

Many New Jerseyans are concerned about accessing their prescription drugs, particularly those living with chronic illnesses. Fortunately, there are many assistance programs provided by drug manufacturers to help offset drug costs, including co-pay assistance programs, which dramatically reduce out-of-pocket costs for patients.

However, the majority of insurance companies are now using co-pay accumulator adjustment programs, which disallow copay assistance from counting towards a patient’s annual deductible or out-of-pocket maximum. As a result, patients can be faced with unexpected costs of up to thousands of dollars to get the medicines they need.

Additionally, these programs often target specialty medications that do not often have generic equivalents available. Some of the most vulnerable patients who require one or more advanced treatments are then left with higher out-of-pocket costs or the decision to forego certain treatments and services – a luxury most living with serious illness cannot afford.

Copay accumulator adjustment programs guide patient decision-making to their detriment. Patients are often prescribed more expensive treatment regimens because it is the only option available that works. Copay assistance would help them improve their health through access to better treatments, if they were able to take advantage of the assistance. 

Read the full letter-to-the-editor in Tapinto Phillisburg.