Findings from Genentech Inc. Update Knowledge of Managed Care and Specialty Pharmacy (Patient Liability, Treatment Adherence, and Treatment Persistence Associated With State Bans of Copay Accumulator Adjustment Programs): Drugs and Therapies – Managed Care and Specialty Pharmacy

Biotech Business Daily

2024 NOV 13 (NewsRx) -- By a News Reporter-Staff News Editor at Biotech Business Daily -- Data detailed on Drugs and Therapies - Managed Care and Specialty Pharmacy have been presented. According to news reporting originating in South San Francisco, California, by NewsRx journalists, research stated, “Health insurers have increased the use of copay accumulator adjustment programs (CAAPs) to control costs; however, some states within the United States have banned the use of CAAPs to protect patients from rising out-of-pocket expenses. To assess the impact of state CAAP bans on patient liability, treatment adherence, and treatment persistence.”

Financial support for this research came from Genentech.

The news reporters obtained a quote from the research from Genentech Inc., “This was a retrospective cohort study using administrative claims recorded in the IQVIA PharMetrics Plus database. Data were extracted for patients with fully insured commercial plans receiving autoimmune or multiple sclerosis drugs between January 1, 2017, and December 31, 2021. Patient liability was defined as the difference in insurer allowed and paid amounts. Treatment adherence was measured as the proportion of days covered over a 1-year period, with ‘adherent’ defined as a proportion of days covered greater than or equal to 80%. Treatment persistence was defined as time from treatment initiation to discontinuation (a period of 60 days without supply of treatment). The analysis compared differences in outcomes in states that implemented a CAAP ban during the study period (Arizona, Georgia, Illinois, Virginia, West Virginia) with states that did not, for before and after the date of ban. States that implemented a CAAP ban had relative reductions in patient liability after the first 2 months, which ranged from 41% to 63%, with monthly savings ranging from $128 to $520. Patients in states with a CAAP ban had 14% greater odds of being adherent to their treatment after policy implementation than patients in states without a CAAP ban and a 13% reduction in risk of discontinuing. The implementation of state legislation to restrict the use of CAAPs in state-regulated plans was associated with reductions in patient liability and improvements in treatment adherence and persistence for the 5 states that were early implementers of a CAAP ban.”

According to the news reporters, the research concluded: “These results may offer insights for states that have recently implemented a CAAP ban, as well as for those considering enacting similar legislation.”

This research has been peer-reviewed.

For more information on this research see: Patient Liability, Treatment Adherence, and Treatment Persistence Associated With State Bans of Copay Accumulator Adjustment Programs. Journal of Managed Care & Specialty Pharmacy, 2024;30(9):909-916. Journal of Managed Care & Specialty Pharmacy can be contacted at: Acad Managed Care Pharmacy, 100 N Pitt St, 400, Alexandria, VA 22314-3134, USA.

Our news correspondents report that additional information may be obtained by contacting William B. Wong, Genentech Inc., South San Francisco, CA 94080, United States. Additional authors for this research include Achal Patel and Danny Sheinson.