More on Capital Finance

New study fuels debate over the value of copay offset cards

David Weldon, Contributor

A new study is adding fuel to the debate over the value of copay offset cards, used to cancel a patient's copayment for prescription medications.

[Also: Modernizing Medicaid pharmacy could save states $33 billion]

Released in December by New Jersey-based Alliance Life Sciences Consulting Group, the study looks at the attitudes of patients, pharmacists, physicians and payers toward prescription copay offset cards.

According to study author Dilip Phadnis, the study was conducted from August to November 2012 and included 600 online survey participants with separate focus groups of physicians, pharmacists and patients.

As of 2012, some 500 pharmaceutical brands are participating in copay offset card programs, and the number is growing, Phadnis said.

"Copay offset cards have grown a great deal in popularity and usage over the past few years," Phadnis said. "Over the years the number of companies offering these cards has increased. Despite this, very little information is available regarding the attitudes and experiences of important stakeholders such as patients, pharmacists, physicians and payers."

Most everyone loves copay cards according to survey data, Phadnis said.

"The patients love them because they can offset the cost of the copay. The physicians love them because the card gives them flexibility with the medications they prescribe. The pharmaceutical companies love them because the cards increase customer loyalty to their products. No one loses out," Phadnis said.

But not everyone agrees that copay offset programs are a boon for all.

Among the detractors is the Pharmaceutical Care Management Association, an organization representing pharmacy benefit managers. As outlined in a recent white paper, the association has taken the position that copay offset practices will add to the rising cost of healthcare in this country.

Copay cards don't eliminate actual costs, they just change who foots that portion of the bill, the organization argues. PCMA's concern is that each time a copay offset card is used, that amount is ultimately passed back to the pharmaceutical companies. According to the group's calculations, those returned copay costs amount to just over $3 billion per year – $32 billion over the next decade. That loss would, in turn, be passed to general consumers (not the original patients), the group says, increasing the cost of healthcare nationally by the same amount.

Mason Teneglia, managing director of the Amundsen Group, a pharmaceutical strategy consulting firm, and a member of Pharmaceutical Executive magazine's editorial board, discounts the PCMA's position.

"Coupons and copay offset programs are the only way of ensuring that a brand's patients can always get affordable access to medications and the most cost-effective way of ensuring patient adherence to prescription therapy," Teneglia wrote recently for The Institute for HealthCare Consumerism. "It seems unfathomable that PCMA could argue that affordability and medication adherence is bad things for patients, employers, insurers or healthcare providers."

Show All Comments