North Carolina Legislature Passes New Copay Accumulator Bill


On September 9, 2021, the North Carolina General Assembly passed Senate Bill 257. This bill provides consumer protections against copay accumulator programs. Recently increasing in prevalence, copay accumulator programs prevent the value of a drug manufacturer’s financial assistance from counting toward a patient’s deductible and maximum out-of-pocket limit, which can have a significant financial impact on patients. Copay accumulator programs can result in patients rationing their medication or abandoning treatment altogether. As such, patients may experience disease progression, relapse, and other adverse events. Under the new law, effective October 1, 2021, insurers and pharmaceutical benefits managers must count any amount paid on the insured’s behalf towards an insured’s out-of-pocket maximum, deductibles, copayments, coinsurance, or other applicable cost-sharing requirements. Read the new law here.


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