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Co-pay accumulators or accumulator adjustment programs are relatively new policies that some pharmacy benefit managers and insurers are using to prohibit manufacturer co-payment cards or other forms of manufacturer assistance from being used to pay down a patient’s deductible or out-of-pocket maximum.
Patients who utilize co-pay coupons from pharmaceutical companies have previously been allowed to count the amount of the coupons (often thousands of dollars) towards their deductible or out-of-pocket maximum. Co-pay accumulator policies prohibit that practice, and the amount of assistance a patient receives from a pharmaceutical company may no longer count to help a patient meet their deductible or out-of-pocket maximum.