In what initially appeared to be a move that directly opposed the efforts of state legislation recently passed in the Virginias, CMS is allowing the use of copay accumulators but only in situations in which a generic drug is available.  Luckily for our cancer patients, this should largely not affect them (as copay cards are generally only available on brands without a generic).  Alas, more legislation will be needed to protect patients in all 50 states and around the world.

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