![]() ![]() What’s more, at least one of these private companies earns fees equal to 25% of the manufacturer’s copay support program. ![]() The two largest PBMs-CVS Health’s Caremark and Cigna’s Express Scripts-have each partnered with secretive and independent private companies to operate specialty drug maximizer programs for their plan sponsor clients. However, maximizers are being implemented very differently from accumulators. I also highlighted why plans have responded to the negative patient impact from accumulators with copay maximizer programs. In Copay Maximizers Are Displacing Accumulators-But CMS Ignores How Payers Leverage Patient Support, I explained a new Centers for Medicare and Medicaid Services (CMS) final rule regarding health plans’ use of copay accumulator adjustment. One minor update: PrudentRx finally has a website! It's still uninformative and misleading, but I suspect that my original article shamed them into putting up a better placeholder. Click here to see the original post and comments from June 2020. It was one of my most popular articles in 2020. This week, I’m rerunning some popular posts while I work on the forthcoming 2020-21 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors. ![]()
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