Out-of-pocket spending for prescription medicines a decade ago consisted almost entirely of fixed copayments, but use of deductibles and coinsurance in commercial health insurance has skyrocketed in recent years. This shift has resulted in many patients with chronic conditions being asked to pay a larger share of the cost of their medicines. Faced with increasing costs each year, a growing share of commercially insured patients rely on cost-sharing assistance programs offered by pharmaceutical manufacturers to help them pay their out-of-pocket costs at the pharmacy counter.