On March 25, Kentucky Governor Andy Beshear signed SB45 into law. The new law limits how state-regulated insurers can implement copay accumulator programs. Such programs prevent the value of a drug manufacturer’s financial assistance from counting toward a patient’s deductible and maximum out-of-pocket limit. This can have a significant financial impact on patients, especially those who are prescribed medications for which there are no generic alternatives. Financial strain can result in patients rationing their medication or abandoning treatment altogether, potentially contributing to disease progression, relapse, or other adverse events. The new law limits the use of copayment accumulators to instances where there is a generic alternative available, and also allows medical professionals to exercise significant control over the process if the brand drug is deemed medically necessary or if the brand drug was obtained through prior authorization, step therapy, or insurer exceptions or appeals. The new law strikes a balance by steering patients toward less costly, medically appropriate generic medications, while recognizing that copay accumulator programs are otherwise inappropriate. Read the new law here.
Last Updated on April 1, 2021 by Aimed Alliance
