Copay Accumulator Programs Block Access to Necessary Cancer Treatments

October 27, 2020

Beginning January 1, UnitedHealthcare (UHC) will ask physicians to provide information on the copay assistance funds patients receive for their treatments. UHC would then enforce a copay accumulator, which would ensure that no copay assistance funds are applied toward patients’ deductibles or out of pocket maximum payments.

In response, the Association for Clinical Oncology (ASCO), along with a dozen other medical specialty societies sent a letter to UHC urging the organization to not move forward with its proposed copay accumulator initiative or physician reporting on copay assistance.

“Our organizations oppose this change as it would endanger patients’ access to care and undermine the doctor-patient relationship,” the organizations said in the letter. “We urge UHC to explore other pathways to rein in drug costs without jeopardizing patients’ health.”

The letter acknowledges that the specialty drugs targeted by this policy are expensive; however, they are also vitally important for patients with serious illnesses such as cancer. Additionally, most of the targeted drugs have no generic equivalents or therapeutic alternatives, meaning patients do not have lower-cost options.

Copay assistance programs allow patients to access potentially life-extending medications with less concern for their personal finances. Blocking copay assistance funds from being applied toward patient deductibles could result in patients facing thousands of dollars in unexpected medical bills and the discontinuation of treatment with disastrous consequences.

Read the full letter.

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