UnitedHealthcare recently announced that, beginning in 2021, it will require network providers to report patient use of manufacturer co-pay assistance for products covered under the major medical benefit. Co-pay accumulators, which to date have been predominantly a pharmacy benefit issue, will now become a critical consideration for products covered under Medical Benefit. Manufacturers offering co-pay assistance for medical benefit products will need to incorporate accumulator mitigation strategies into their program design, and establish monitoring capabilities to assess the impact of this new payer dynamic for their brand.

  • Discuss program design considerations for pharmaceutical manufacturers to address the potential impact of this new policy
  • Assess and quantify the impact to a manufacturer assistance program
  • Examine potential provider reactions to these policies and how they will shape manufacturer strategies

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