Health Insurers Are Coming After Your Copay Coupons

Last week, Real Clear Health ran an op-ed by Terry Wilcox, executive director of Patients Rising, discussing perhaps the biggest prescription drug access development of 2018: Copay Accumulator Programs. Insurance providers limiting copay coupons with the introduction of copay accumulator programs. As she explains:

1) Copay Coupons Are An Increasingly Popular Way To Offset Prescription Drug Costs

Copay coupons are aid that drug manufacturers provide directly to patients to help them cover their copay costs, which can easily reach hundreds of dollars per prescription… The health care consultancy IMSQuintiles estimates that 19 percent of total prescriptions were filled using copay coupons in 2016, nearly 50 percent more than in 2013.

2) In An Attempt To Pass Even More Of Health Care Costs On To Patients, Insurers Are Coming After Coupons With Copay Accumulator Plans

In a misguided attempt to ensure patients “have skin in the game,” many insurance plans began disallowing copay coupons to count toward their deductibles this year. Under these [copay accumulator] plans, insurance companies now expect patients who use copay coupons to also personally pay their deductibles, dramatically increasing their out of pocket costs.

3) Rather Than Steering Patients To A Cheaper Alternative, Copay Accumulators Will Reduce Access Entirely

[F]or many conditions, cheaper alternatives do not exist. According to a recent USC study, 90 of the top 200 drugs use coupons. Of those 90 medicines, 71 have no generic equivalent. The “cheaper alternative” for many patients on fixed incomes is not taking their needed medications at all. In other words, it’s true that copay accumulator programs will decrease patient use of their medicines. But at what cost?

Patients Rising argues that copay coupons must be protected. Patients and legislators must rise up to make their voices heard.
Read the full op-ed here.

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