Top Takeaways from CBI Coupon and Copay

At CBI’s eighth annual Coupon & Copay Forum in October, industry experts gathered virtually to discuss a range of important topics with an audience of pharma leaders and service providers charged with patient access. With 75 companies represented, and 75% attending from life science companies, the conference had a strong cross-section of participation including brand management, market access, reimbursement, patient support, and trade.

As conference chair, I noticed several key themes that emerged from the conversations:

Copay Accumulators Continue to Gain Attention

Because copay accumulator adjustor programs (CAAPs) continue to play an integral role in a pharma brand’s affordability budget and market access strategy, the topic was a popular one. Described differently by insurers that offer them, these programs are gaining traction: As of 2019, approximately a third of employers were using some form of CAAP, with another 19% considering expanding their programs in the next few years. Nearly 6% of patients were impacted in 2018, with that number expected to increase to 8.5% by the end of this year.

COVID’s impact on job loss has created delays in medical care, disruptions in the ability of patients to fill prescriptions, and swings in employer-sponsored healthcare over the past several months. It has prompted employers to look more closely at disparities and equity concerns among employees and as a result, they are recognizing the business value of operationalizing Disability Equity Inclusion (DEI) initiatives. Benefits equity has been a delayed focus, however, and a one-size-fits-all approach may not be good for everyone. For CAAPs, this approach has the potential to exacerbate specialty drug benefit inequities, and a more significant focus on equitable benefit design, particularly for specialty medications, is needed.