Prescription-Drug Coupons: No Such Thing as a Free Lunch — NEJM

Filed Under: Costs, Health plans, Patients

pills on tableTo go along with the recent guest post here about drug discount cards from Richard J. Sagall,  founder of Needymeds, here’s an excerpt from an excellent piece in the New England Journal of Medicine about prescription drug coupons:

“We found (by searching the Food and Drug Administration [FDA] website and the Tarascon Pharmacopoeia) that a lower-cost FDA-approved therapeutic equivalent was available for 8% of the drugs in our sample (31 of 374 …). For more than half the remaining products (58%, 200 of 343), there was a lower-cost generic alternative within the same drug class. Thus, 62% of coupons (231 of 374) were for brand-name medications for which lower-cost therapeutic alternatives were available.

“The widespread availability of coupons for brand-name pharmaceuticals that can be expected to be used long term and for which lower-cost alternatives are available has important implications for patients. Despite the short-term savings achievable with coupons, they do not offset higher long-term costs, because they’re nearly always time-delimited. Some coupons can be used once, and others more than once. But we found few that offered savings for more than a year. Once a coupon program ends, patients with chronic diseases face copayments for these brand-name medications that are higher than those for generic alternatives. By that point, however, patients may have developed loyalty to the particular brand or may be skeptical about switching away from a medication that they perceive as effective — or they may not even be aware of alternative therapies. Physicians have been slow to switch patients from brand-name medications to available generic versions,4 either because of clinical inertia or simply because they are unaware of the cost implications of their prescription choices.” Joseph S. Ross, M.D., and Aaron S. Kesselheim, M.D., J.D., M.P.H., Prescription-Drug Coupons — No Such Thing as a Free Lunch — NEJM, Aug. 28. 2013