We are looking for any biomarker or copay accumulator stories that we can turn into media advocacy pieces!
Biomarkers are signs in your body, such as genes or proteins, that can help you figure out how well a treatment might work for you. You all know best that Arthritis is a complex condition that affects different people in different ways. To manage it properly, we need to understand it first. Arthritis symptoms can be tricky and might look like other illnesses, so it's crucial to use biomarker tests to accurately diagnose, predict how the disease might progress, and plan the best treatment.
Copay Accumulator Adjustment programs prevent any co-payment assistance that may be available for high-cost specialty drugs from counting toward a patient’s deductible or maximum out-of-pocket expenses. Many pharmaceutical manufacturers offer co-pay cards that help cover a patient’s portion of drug costs. Traditionally, pharmacy benefit managers have allowed these co-pay card payments to count toward the deductible required by a patient’s health insurance plan. With an accumulator adjustment program, patients are still allowed to apply the co-pay card benefits to pay for their medications up to the full limit of the cards, but when that limit is met, the patient is required to pay their full deductible before cost-sharing protections kick in.
Fill out this survey to get your story in, and we will follow up with any opportunities.
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Would you like to support our media advocacy campaign in OH by completing a letter to the editor, op-ed, or other form of media advocacy?
Do you have any questions we can answer?
Has your health insurance ever stopped counting copay assistance toward your out of pocket maximum?
How did this affect your ability to afford your medication?
What challenges, if any, have you faced because of copay accumulator programs, and how have these impacted your health?
Has your doctor ever mentioned biomarker testing as part of your arthritis diagnosis or treatment plan?
Have you ever had to wait to get a biomarker test, or been told it wasn’t covered by insurance?
Did not having access to biomarker testing delay getting the treatment that worked for you? What challenges have you faced in getting tested for biomarkers—cost, access, insurance rules, or something else?
If you were able to get a biomarker test, how did it affect your treatment decisions or your doctor’s plan? Looking back, do you wish biomarker testing had been part of your care sooner?
