CAAP bans benefit patients

A recent study sheds light on the effectiveness of state legislation banning copay accumulator adjustment programs (CAAPs) in state-regulated health plans. The research, which the authors say is the first to assess real-world implications of state legislation prohibiting the use of CAAPs for state-regulated health plans, reveals a significant correlation between CAAP bans and improved patient outcomes, particularly for those with autoimmune conditions and multiple sclerosis. It focused on five states that were early adopters of CAAP ban legislation.

Key Findings

The study's results show the following of the benefits of CAAP bans:

• Lower Patient Liability: States that implemented CAAP bans saw a notable decrease in patient out-of-pocket expenses compared to pre-ban levels.
• Improved Treatment Adherence: Patients in states with CAAP bans demonstrated better adherence to their prescribed treatments.
• Enhanced Treatment Persistence: The research showed that patients were more likely to continue their treatments long-term in states where CAAPs were prohibited.

Implications for Policymakers and Patients

This research, published in the Journal of Managed Care + Specialty Pharmacy (JMCP), provides the following insights for both policymakers and patients:

• For states that have recently enacted CAAP bans, these findings offer encouragement and potential benchmarks for success.
• States considering similar legislation now have evidence to support their decision-making process.
• Patients in states with CAAP bans may experience reduced financial burden and improved health outcomes.
• The authors wrote that additional attention be paid to the health equity impact of CAAPs, as well as potential federal solutions to address the variation in access for patients across the United States.

The research was funded by Genentech.

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