WASHINGTON — The Biden administration is appealing a court ruling against a Trump-era regulation that aimed to protect the way health insurance companies handle some prescription drug costs — a rare moment of harmony between the two administration’s approaches to drug pricing reform.
At issue is a health insurance industry practice of not counting drug company coinsurance assistance toward a patient’s out-of-pocket costs. Health plans use tools, called copay accumulators, to keep tabs on whether patients or drug companies were paying the tab for a certain medicine — and don’t count any drug company assistance toward a patient’s deductible or plan maximum.
Insurers say they’re trying to control drug prices. When a drug company pays a patient’s share of a drug’s price, it’s easier to maintain a high price because patients stop caring about it. Medicare bans drug company coinsurance assistance on similar reasoning.