An article in the New York Times (April 12,2012) describes efforts to cap the patient co-pay amounts to shield them from he high cost of specialty drugs – that account for 1% of the units sold but 17 % of the cost. Opponents claim that the only beneficiaries will be pharmaceutical companies, who will be shielded from the demand impact of their costs. But others claim that this will put pressure on health insurance companies to adjust their margins. Will caps on patient co-pays prevent customers from being forced to forgo treatment or will they decrease availability of such treatments altogether ? Are pharmaceutical companies let off the hook by such rules ? How should one infuse competition in these markets, given the high research costs for discovery and approval of these drugs ?