In recent years, the adoption of alternative funding programs (AFPs) among self-funded employer-sponsored plans has risen rapidly. However, few employers realize that AFPs can harm employee health and may deplete essential resources for truly underinsured or uninsured patients. In response, Aimed Alliance has collaborated with nine other advocacy groups to coauthor a new white paper, “Alternative Funding Programs: What Employers Need to Know.”
AFPs are designed by for-profit third-party vendors and marketed as a cost-saving tactic for self-funded employer plans. The vendor works with the employer-sponsored plan to exclude specialty drugs from coverage or deny prior authorization so employees may qualify for and procure their medications from a manufacturer patient assistance program (PAP), which supplies prescription drugs at no cost directly to consumers. This may bring about significant ethical and legal issues including:
- Delayed treatment access;
- Privacy concerns;
- Inequitable health benefits; and
- Potential violations of the Employee Retirement Income Security Act (ERISA), Food and Drug Administration (FDA) drug importation policies, and the Affordable Care Act (ACA), among others.
Learn more by reading the paper here.
This white paper was prepared by Innopiphany LLC. and supported by Boehringer Ingelheim Pharmaceuticals, Inc.
Last Updated on February 12, 2024 by Aimed Alliance
