LANSING, MI – Yesterday, Sen. Stephanie Chang introduced legislation that would address insurance companies' copay accumulator adjustment programs and ensure Michiganders receive the total value of prescription drug assistance to afford their treatments, improving access to care for Michiganders.
“Being diagnosed with ovarian cancer was hard enough, but trying to manage my medical expenses made it even harder,” said Stacey Goins, ovarian cancer patient from Greenville, MI. “When my oncologist signed me up for prescription drug copay assistance, I was relieved, thinking that one cost would be covered. I later discovered that my insurance company wasn’t counting the copay assistance payments toward my out-of-pocket max for the year. Michigan lawmakers need to do something to make it easier for cancer patients and those facing chronic disease to get their medication.”
Many cancer patients and patients with chronic conditions have difficulty affording the cost of their prescription drugs, regardless of whether they are insured. This is especially true for newer drugs, including cancer drugs, that do not yet have a generic equivalent. Manufacturer programs and charitable patient assistance programs help many cancer patients afford their medications. A patient assistance program’s financial support can provide patients with access to a life-saving drug they might otherwise be unable to afford.
Copay accumulator adjustment programs allow the enrollee to use copay support, but the amount of the support does not count towards the enrollee’s maximum out-of-pocket (MOOP). Only the funds spent directly by the enrollee (and not on their behalf) would count towards the enrollee’s MOOP, creating a financial barrier for patients.
“The American Cancer Society Cancer Action Network (ACS CAN) thanks Sen. Chang for championing this critical step in improving access to prescription drugs for individuals with cancer and other illnesses and looks forward to working with the rest of the legislature to pass this important legislation, said Molly Medenblik, ACS CAN Michigan government relations director. “An estimated 68,730 Michiganders will be diagnosed with cancer, and 21,580 are expected to die from the devastating disease this year.”