Bass, Berry & Sims attorney Shannon Wiley provided insight for an article outlining the impact that drug manufacturer funded programs have for patients receiving high cost drug therapies. In the article, Shannon discusses the legal differences between patient assistance programs (PAPs), typically for patients without insurance and “copay coupon” programs for those with insurance. As Shannon points out in the article “[t]here are legal requirements associated with providing both types of assistance. For example, ‘copay coupons are not available to patients with insurance under a federal program, such as Medicare Part D.'” Shannon also addresses contractual payor prohibitions of copay coupon use, “‘[m]any specialty pharmacies don’t have the leverage to keep copay coupon prohibitions out of payor agreements so the real issue for SPs is to establish a protocol to honor the prohibition.'”
The full article, “PAPs Offer Safety Net for Soaring Drug Prices,” was published in the February 2015 issue of Specialty Pharmacy Continuum and is available online to subscribers.