U.S. Rep. Rodney Davis (R-IL) recently led a bipartisan contingent of more than 55 of his colleagues in requesting that President Joe Biden reverse a policy change that would help lower prescription drug prices for Americans.
Specifically, the lawmakers asked the president to reverse the copay accumulator policy change included in the 2021 Notice of Benefit and Payment Parameters (NBPP), which the U.S. Department of Health and Human Services (HHS) adopted during the previous administration.
The 2021 NBPP permits health insurance issuers and pharmacy benefit managers to adopt a practice referred to as a “copay accumulator adjustment program,” which permits issuers to exclude cost-sharing assistance toward a patient’s out-of-pocket maximum, making it difficult for patients to afford their medicines, according to a March 18 letter Rep. Davis and the lawmakers sent to Biden.
“During a global pandemic, we should be doing everything we can to increase affordability of prescription drugs, not decrease it,” wrote Rep. Davis and the members. “Reversing the 2021 NBPP copay accumulator policy will help people save more money at the pharmacy counter. We urge you to consider reversing this policy to enable Americans to afford the lifesaving medication they rely on.”
Rep. Davis and his colleagues think that the 2021 NBPP does not align with the HHS regulation defining cost-sharing, which includes payments made by or on behalf of an insured, nor does it align with congressional intent in defining cost-sharing and establishing the annual limit on cost-sharing, according to their letter, which is supported by the All Copays Count Coalition, including The AIDS Institute, the Cancer Support Community, the National Hemophilia Foundation, and more than 60 other organizations.
“With patient out-of-pocket costs increasing, we support regulatory changes that improve affordability,” wrote Rep. Davis and his colleagues. “It is our fear that many patients will have to ration their medicines, or abandon their prescriptions altogether, which could lead to more serious health outcomes and higher costs.”