Insurance Card (Photo: Shutterstock)

A coalition of patient groups are taking the federal government to court over regulatory changes regarding “copay accumulators,” a complicated piece of the health care payment puzzle that could result in patients having much higher costs, if the changes stay in place. But some in the industry say the lawsuit is just one move in a much larger conflict between drug industry forces.

The patient groups argue that the copay accumulators that Pharmacy Benefit Managers (PBMs) use have the effect of sharply increasing the amount that patients pay. Industry insiders see the practice as an attempt by PBMs to indirectly shift costs, but as with other health care strategies, consumers can end up caught in the middle.

Complete your profile to continue reading and get FREE access to, part of your ALM digital membership.

Your access to unlimited content isn’t changing.
Once you are an ALM digital member, you’ll receive:

  • Critical information including cutting edge post-reform success strategies, access to educational webcasts and videos, resources from industry leaders, and informative Newsletters.
  • Exclusive discounts on ALM, BenefitsPRO magazine and events.
  • Access to other award-winning ALM websites including and

Already have an account?



Join BenefitsPRO

Don’t miss crucial news and insights you need to navigate the shifting employee benefits industry. Join now!

  • Unlimited access to - your roadmap to thriving in a disrupted environment
  • Access to other award-winning ALM websites including and
  • Exclusive discounts on and ALM events.

Already have an account? Sign In Now
Join BenefitsPRO

Copyright © 2023 ALM Global, LLC. All Rights Reserved.