The Hidden Dangers of Alternative Funding Programs

Government and regulatory partner Libby Baney and manager Maya Bolter explained how commercially insured patients who use alternative funding programs (AFP) can be at risk of receiving counterfeit or substandard medication from unregulated drug manufacturers in their published White Paper “The Hidden Dangers of Alternative Funding Programs.”

Baney and Bolter explained that some insurance vendors implement cost-cutting strategies, such as programs that facilitate the provision of prescription drugs from foreign pharmacies to commercially insured U.S. patients. In these cases, an employer health plan will work with a third-party vendor to promote AFPs to cut employer costs under their health plan. AFP payers provide minimal coverage for drug’s under the plan’s formulary, and patient’s are told the drug is not covered or that insurance will pay for a small portion of the cost if they try to obtain it from a domestic pharmacy. The patient is then referred to a vendor who can provide the prescription at a reduced cost, sourcing it through an unregulated, foreign manufacturer.