AbbVie has filed a lawsuit against a behind-the-scenes company that helps health plan sponsors take advantage of the assistance programs created by drug companies to provide specialty medicines to patients for free.
At issue is a maneuver called alternative funding, which a growing number of drugmakers contend exploits their charitable programs. Basically, a plan sponsor excludes certain expensive drugs from coverage and taps an outside vendor to help patients obtain the medicines for free from patient assistance programs run by drug makers or foundations.
By doing so, plan sponsors — usually employers that fund their own health coverage — no longer have to pay for the medicines. Instead, the drugmaker bears the cost. Typically, drug companies provide free medicines directly through their own assistance programs or work with foundations, many of which receive some funding from drug companies and are devoted to helping uninsured or underinsured patients with specific diseases.
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