PCMA support letter for AB 265. PCMA is supportive of programs that facilitate patient access to specialty and high-cost drugs when appropriate; however, we do not support programs that undermine formulary design, since additional expenditures do not necessarily provide patients with additional health benefits. Employer costs rise dramatically when enrollees choose expensive drugs over more affordable options, and since the use of copay coupons reduces the utilization of these more affordable options, restrictions on copay coupon usecan be part of a solution to help slow the rising cost of prescription drug coverage.