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Copay Coupons Are Costing You

posted by Alicia Caramenico

on July 11, 2016

While drug copay coupons may appear to help consumers, that’s not actually what they’re designed to do. What drug copay coupons really do is keep costs high for everyone.

To better understand how these “clever marketing tools” work to drive up costs for all of us, we can look at the recent experience of ProPublica reporter Charles Ornstein. His wife used a copay coupon to pay for their son’s prescription for brand-name ear drops. As his ProPublica piece explained, copay coupons have the effect of steering patients towards more expensive brand-name treatments. This is especially problematic for all of us when less costly and equally effective alternatives are available.

Moreover, these coupons enable drugmakers to subsidize patients’ share of treatment cost and satisfy their deductible requirements. This prevents patients from directly experiencing the high costs of these drugs and ultimately removes any incentives for patients to opt for lower-cost treatment options. In this way, the coupons make the true cost of a drug essentially unknowable, Ornstein noted. The true costs are locked in the “black box” of drug pricing.

Meanwhile, insurers are left to foot the bill for the entire treatment cost, which gets passed on to consumers and employers in the form of higher premiums.

These copay coupons forgo or reduce patients’ payments on drugs without addressing a major driver of higher costs for patients – the high price of the actual drug. Until drugmakers address sky-high prescription drug prices, these coupons will continue to make health care unaffordable for everyone.