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Copayments Not Counting Toward the Deductible Could Have Unintended Consequences
Abstract:
Starting this year, many PBMs rolled out a new type of cost-share program that will not count copay assistance dollars toward a patient's deductible and out-of-pocket maximum. This might put some patients in a bind. Patients face big, unaffordable drug bills when the assistance maximum is reached, but before they have met their deductibles. Adherence to the specialty drug could fall off sharply if patients hit the copay program limit and cannot afford therapy.
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