by Angela Sams
Many of us have probably at some time or another been faced with an expensive prescription that we wish we didn’t have to pay for, instead wishing for some kind of coupon or discount to help foot the bill. According to a recent article in Bloomberg Business, some pharmaceutical companies are providing just that, spending approximately $7 billion to generate discounts and coupons for patients’ drug co-payments.
Why are some prescriptions so wildly expensive? The short answer is that insurance companies want the drugs to be so unaffordable that patients won’t use them. Much to the chagrin of insurers, pharmaceutical companies have responded by paying for patients’ prescription co-pays, handing the rest of the balance right back to insurers. This is not allowed everywhere, however. Because the cost of a patient’s co-pay directly influences whether or not they will pay for their prescription, co-pay coupons are banned in the Medicare program, cited as an illegal inducement.
Drug companies see the coupons—distributed online, in magazines, and in doctor’s offices—as helpful to consumers. Holly Campbell of the trade group Pharmaceutical Research and Manufacturers of America states that “co-pay offset programs can play an important role in maintaining access to needed medicines, especially for patients taking specialty medicines or with chronic conditions.” But providing these coupons helps the drug companies as well. Indeed, they “can earn a 4-to-1 to 6-to-1 return on investment on co-pay coupon programs.”
Insurance companies are resisting the coupons by nixing drugs from their plans, and creating a rewards program that would give cash to patients who don’t use the coupons. United Healthcare has been leading the way in the fight against the co-pay coupons, in part due to the fact that the discounts can keep patients from seeking drug alternatives that are equivalent to the more expensive option. A spokeswoman for United argues that when consumers choose a pricier drug because they have a coupon, this can have a huge impact on healthcare costs overall. The battle between insurers and drug-makers leaves consumers caught somewhere in the middle. And it leaves one to wonder, could the problem potentially be solved if drug prices were simply lowered?