AHIP backs HHS in challenge to agency's copay coupon policies

AHIP is backing an HHS policy that allows insurers not to count copay coupons toward out-of-pocket maximums. 

The trade association filed an amicus brief in HIV and Hepatitis Policy Institute v. United States Department of Health and Human Services on March 23, supporting HHS' copay accumulator policy, which allows insurers to not count assistance from pharmaceutical companies toward out-of-pocket maximums. 

In the lawsuit, the HIV and Hepatitis Policy Institute, an advocacy group whose backers include some pharmaceutical manufacturers, argues a 2021 HHS copay accumulator policy is illegal. 

In the brief, AHIP said copay coupons are "profit maximizers" for manufacturers. 

"They are not need-based subsidies. Instead, they are marketing tools designed to maximize profits, crafted to ensure that health plans maximize spending for prescription drugs, while minimizing the amount of manufacturer assistance," the group wrote in the brief. "This results in drug prices going up for all consumers, including coupon recipients, who ultimately pay higher health insurance premiums." 

Opposing actions to end copay accumulators are among AHIP's priorities for 2023. 

According to a report from Avalere, 16 states have passed legislation banning copay accumulators. 

Read the full brief here. 

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