Employers generally want to provide comprehensive medical and pharmacy benefits to their employees, but many organizations and their employees are struggling to cover healthcare costs. In 2018–2023, the average annual premium for family coverage in the commercial market increased by 22 percent. In 2024, employer healthcare costs are expected to continue increasing. In recent years, alternative funding program (AFP) vendors have emerged as a means for employers to offset drug spending for beneficiaries of their employer-sponsored plan.
Although the inner workings and operating procedures of AFPs generally lack transparency, what we do know raises a slew of important questions related to legality, sustainability of cost shifting, the general lack of patient-centeredness in our healthcare system, and what we should be thinking about regarding the proliferation of AFPs.