Coupons Lowering the Price of Your Meds May Lead to Insurers Dropping Them from Your Plan


There is no free lunch but there is no shortage of marketing gimmicks from the pharmaceutical industry. Big Pharma would like you to know how warm and cuddly it is and one way is to brag about coupons it offers to lower the price of your meds and its “patient assistance” programs. You definitely could save money through these methods but you may end up not having any insurance coverage for your meds in the future.

When people who need or want their meds pay a lot for them they complain. They complain to the drug companies, insurance companies, their doctors and pharmacists. One way to end the complaints and for Big Pharma to do its Knight in Shining Armor routine is to hand out coupons so those using the meds will have reduced or no co-pays for their meds. Sounds good, doesn’t it?

The high cost of new meds is a major issue for the healthcare system. Many of them don’t do much to improve the quality or quantity of life for patients but drug companies need to show a good return for investors. They will warm up their marketing machine, pay all kinds of money on advertising and sweeten the deal with coupons. But who ends up paying the cost of insanely high cost meds? We all do.

One example of this practice is the toe nail anti-fungal medication Jublia, according to Bloomberg. When Valeant Pharmaceuticals International rolled out the product last year its advertising offered coupons for eligible patients that would cover their co-pays. Without them Valeant would have a tougher time pushing the product because an eight milliliter container (which is about a teaspoon and a half) of Jublia goes for $1000.

Rodney Warner
Rodney Warner

Employers and insurers are trying to reduce their costs by increasing co-pays for meds. Since this could lower demand for meds, Big Pharma is pushing back to eliminate the co-pay and increase sales. In 2015 the industry spent an estimated $7 billion (seven times what it did in 2010) to distribute coupons and discount cards to cover some or all patient copayments for drugs from fibromyalgia pain treatments to diabetes pills.

Research shows this is a good investment by Big Pharma because, not surprisingly, how much patients pay for a prescription affects their willingness to buy it. If a patient has a copay more than $50 he or she is more than four times more likely not to buy it compared to when there is no copay, according to a 2010 study published in the Annals of Internal Medicine. Coupons are so effective at increasing patient demand they are not allowed in the federal Medicare program, where they’re considered an illegal inducement.

Coupons are good for business. Big Pharma can earn a 4-to-1 to 6-to-1 return on investment on copay coupon programs, according to the Pharmaceutical Care Management Association. Where else can you earn that kind of money on an investment?

These coupons can mean more money in your pocket but the big picture isn’t so bright.

  • The advertising and coupons drive increased use of new, expensive treatments that may not work as well as older, less expensive ones. This increases the cost of everyone’s health care. One 2013 analysis published in the New England Journal of Medicine stated 62% of coupons studied covered brand name drugs for conditions that had lower-cost alternatives available. Older medicines competing with Jublia can cost $30 or less.
  • In order to save money insurers and benefits managers are dropping coverage of expensive drugs using aggressive coupon campaigns.

Patients need to be informed and aware that drug companies are trying to manipulate them into asking their physicians for new, expensive medications that may not work any better than older, less expensive alternatives. One way to do that is to reduce or eliminate your co-pay with coupons.

If you need a new medication and can take advantage of savings from coupons, more power to you. If not, trying something older and less expensive may be better for you and everyone else who pays for health care.

 

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