Aimed Alliance Asks HHS and CMS to Freeze and Revoke Recent Changes to the Medicaid Best Price Rule


On February 3, 2021, Aimed Alliance submitted a letter requesting CMS freeze and revise a recently passed rule on Medicaid Value-Based Purchasing. The rule, which is scheduled to go into effect on March 1, 2021, would require copay assistance to be counted toward the calculation of a prescription medication’s best price if a health plan has implemented a copay accumulator program. This would disincentivize drug manufacturers from providing copay assistance to vulnerable patients who may not be able to afford medically necessary treatments. This limit on copay assistance would be compounded with the medical and financial difficulties imposed on patients by copay accumulator programs, which increase financial strain on patients and can lead to decreased medication adherence. Aimed Alliance argues that under the current rule, manufacturers would be unable to determine if a health plan has adopted a copay accumulator program for a particular medication, and would likely abandon offering any copay assistance. As such, Aimed Alliance argues that CMS should either reverse these changes or prohibit health plans from implementing copay accumulator programs altogether, as CMS has explicitly acknowledge the harm these programs may have on patients. Read our letter here.


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