May 20, 2022
  • A federal judge struck down a controversial rule that requires drug companies to include copay assistance like coupons into Medicaid rebates. District Court Judge Carl Nichols said that because the rebate statute only refers to the best price made to the insurer and not the patient, the final rule contradicts the federal law and must be struck down. The ruling is a win for the pharmaceutical industry and a loss for insurers and pharmacy benefit managers (PBMs) that have adopted copay accumulator programs that limit the impact of drugmaker assistance from counting toward the deductible and out-of-pocket caps. (Article here)