I don’t often side with global pharmaceutical companies but on the issue of their copay drug coupon handouts I do…but only kind of. Not to be mistaken with prescription discount cards, which are used by people who pay out-of-pocket and not with their insurance (if they have it), drug companies are increasingly giving away copay coupons to cover the copayments of expensive drugs – often for specialty medications but for traditional prescription drug as well. These coupons cover some of even all of your copayment. That’s really cool! Thanks Big Pharma.
The problem is that your health insurance company is still footing the bill for the drug and while you may be OK with that, UnitedHealth, Aetna, etc. — Big Health — are not. Now don’t get too happy because higher drug costs for health insurance companies often lead to higher deductibles and premiums that you will have to pay. And there’s worse.
It is argued that that copay coupons exacerbate the problem of high drug prices, as recently reported in ProPublica. The health insurance companies working through the pharmacy benefit managers, such as Express Scripts, who have also been critical of the coupons, are trying to contain costs by steering patients to lower cost drugs, particularly generics. But if a drug company is willing to pay your copayment for the brand then why bother paying the copayment for the generic? But Big Pharma still gets paid by Big Health. Clever.
Befitting its opinion, Express Scripts titled a blog post “The Dark Side of Copay Coupons” in which we read that drug companies are “using the coupons to neutralize the financial incentives that plans use to encourage the use of clinically equivalent but lower-priced medications, chiefly generics.” That’s mumbo jumbo PBM speak to say: “Hey, we want our members to fill their scripts with a generic drug because it makes us more money than when we have pay for your shiny brand so stop being tricky with legal kickbacks to consumers.”
Bottom line: these coupons don’t address the problem of skyrocketing drug prices in America and probably make it worse. But so what? We know that lower out-of-pocket costs mean less people skipping prescribed medications and that leads to better health outcomes. I argue it all the time when it comes to international online pharmacies and why they are a critical lifeline when domestic costs are too high.
If big pharma wants to pay for your share of a drug’s cost bully for you. There’s a war between Big Pharma and Big Health about who can milk more profits out of the American consumer and if the fallout leaves you some money on the table then take it. Longer term policies to bring down drug prices are the answer — ones we advocate for through Prescription Justice Action Group. In the meantime, Americans have to get their prescriptions filled however they can: low cost generic drug programs, prescription discount cards, copay coupons, patient assistance programs and international online pharmacies.