Summary: “Visit nearly any official website for a brand-name drug available in the United States and, mixed in with links to prescribing and safety information, you’ll find links to drug “coupons,” including copayment-assistance programs and monthly savings cards. Most offers are variations on ‘Why pay more? With the [drug] savings card, you can get [drug] for only $18 per prescription if eligible’ or ‘Get a free 30-capsule trial of [drug] with your doctor’s prescription and ask your doctor if [drug] is right for you.’ Why do manufacturers offer drug coupons? Are they good for patients in the long run? Are they even legal?” two doctors ask in a piece in the New England Journal of Medicine.
“Commercial drug-insurance plans typically have tiered pharmaceutical formularies to guide prescription-drug use, requiring relatively small patient copayments (approximately $5 to $15) for inexpensive generic drugs and higher copayments (perhaps $25 to $100) for brand-name drugs. Manufacturers use coupons to reimburse patients for this difference in copayments when they buy brand-name medications, so that, for people with commercial insurance coverage, the out-of-pocket costs are the same as those for generic drugs.
“Drug coupons are implemented through subsidies paid by drug manufacturers. …
“It has famously been said that “there is no such thing as a free lunch.” Drug coupons are no exception to this rule. Everyone likes to save money, and coupons for essential therapies may be helpful for certain patients, particularly those with life-threatening conditions for which there are not reasonable generic substitutes. However, the majority of drug coupons are for therapies for which lower-cost and potentially equally effective alternatives exist. Physicians need to talk to their commercially insured patients about the implications of drug-coupon use and make sure that their inclination to reduce short-term out-of-pocket spending doesn’t come at the cost of higher long-term expenses for themselves and society.” Joseph S. Ross, M.D., and Aaron S. Kesselheim, M.D., J.D., M.P., Prescription-Drug Coupons — No Such Thing as a Free Lunch — New England Journal of Medicine.
