This posting from Truveris highlights the tremendous cost savings associated with both the "Accumulator" and "Maximizer" benefit designs employers have used to help combat the sky rocketing costs of specialty medications.
The author clearly points out the pitfalls that can occur to a patient when an employer implements an "Accumulator" benefit design but also does a good job of including the positive impact to the patient when a "Maximizer" benefit design is in place.
With Accumulators they outline that patient compliance could be harmed when they are left with a large copayment after the manufacturer marketing money (copay assistance program) is exhausted. This could lead to a patient dropping off of therapy. With Maximizer benefit designs, the patient's copayment remains at $0, even after the manufacturer assistance is exhausted. This should have an extremely positive impact on patient compliance.
Whether by oversight or design Truveris then seems to lump both benefit designs together as harming the patient and enriching the employer. There is a clear difference between the two benefit designs and Maximizers that potentially improves patient adherence and compliance, measures very important to payers and manufacturers, should not be lumped in with Accumulators that leaves the patient holding the bag.
The main complaint about the Maximizer benefit is that the manufacturer marketing money is not allowed to accumulate the their deductible and out-of-pocket maximum to subsidized the patient's remaining medical costs.
Something that most employers are grateful for.