Saturday, December 16, 2017
Health

Discount coupons for brand-name drugs are abundant

A magazine ad for the testosterone drug AndroGel shows a discount card that allows consumers to pay "as little as $10 per month" for the medicine. Drugmaker GlaxoSmithKline announces in another magazine that it offers discount coupons for the popular inhaler Advair. And a TV commercial for Nexium notes that if consumers can't afford the heartburn drug, its manufacturer, AstraZeneca, "may be able to help."

In the past few years, coupons and discount cards have become nearly ubiquitous for prescription drugs. Such incentives are available for 395 medications, according to a recent report from industry consultant IMS Health. In a similar analysis in 2009, a marketing firm found that only 86 drugs came with coupons.

Drugmakers say the coupons help Americans get the medicine they need. But the insurance industry is concerned that they drive patients toward more expensive brand-name drugs, leaving insurers to cover the full cost, which then gets passed on to consumers.

"An individual patient who receives a coupon might not realize that, although that particular prescription may cost less that month, overall what it does is to raise costs for everyone, including themselves," said Susan Pisano, a spokeswoman for the industry trade group America's Health Insurance Plans.

For people using Medicare, Medicaid, veterans benefits or any other federal health insurance program, using a coupon or a discount card to buy prescription medication works against efforts to keep federal spending down and may also be counter to federal law, according to some experts' interpretation.

Prescription drug coupons represent the latest battle in a war between health insurers and the pharmaceutical industry.

Insurers set high co-pays for brand-name drugs to steer their members to less-expensive generics. In response, companies such as Merck, AstraZeneca, Pfizer and many others issue coupons or discount cards that cover that co-pay.

A recent article in the Journal of the American Medical Association outlined the dramatic effect coupons can have on prices paid by consumers. Using cholesterol-lowering drugs as an example, researchers found that the popular statin Lipitor comes with an average co-pay of $30 a month, compared with a $10-a-month co-pay for simvastatin, a generic drug also used to treat high cholesterol. But with a coupon from Pfizer, the drug's manufacturer, the co-pay for Lipitor goes down to $4 a month, making it less expensive for the consumer than simvastatin.

It's a great deal for the patient but not the insurer. According to the JAMA article, the insurer pays $18 a month for simvastatin and $137 a month for Lipitor.

The coupons are "designed to get patients to bang down their doctor's door and say, 'Give me the most expensive drug,' " said Mark Merritt, president of the Pharmaceutical Care Management Association.

Merritt said that, since insurers ultimately end up footing the bill for the more expensive brand-name drug, they may respond by increasing premiums on everyone.

Drugmakers argue the coupons save money by preventing health problems that occur when patients cannot afford prescribed medications.

The coupon war is now being fought in state legislatures and in court. Earlier this year, several union health plans filed a class-action lawsuit asking a judge to find the use of coupons illegal.

The cost issue surrounding coupons is made even more complicated when the federal government is the insurer.

According to federal statutes, it is a crime to provide "any remuneration to induce or reward referrals reimbursable by a federal health care program." Some experts say coupons constitute such remuneration because they encourage consumers to purchase a more expensive product, with the extra cost ultimately falling on taxpayers. A 2010 report from the Congressional Budget Office found that Medicare pays an additional $76 every time a senior chooses a brand-name drug over a generic.

Even officials within the pharmaceutical and insurance industries said coupons should not be used by beneficiaries of government health programs.

But according to Donald White, a spokesman for the Department of Health and Human Services, no court or administrative body has ever ruled that coupons are illegal. HHS has never prosecuted anyone for issuing or using coupons in the federal health programs.

Comments
Pigs can be therapy animals too. So can horses and rats and cats and llamas and … (w/video)

Pigs can be therapy animals too. So can horses and rats and cats and llamas and … (w/video)

Shrieks of laughter echoed off the walls of the hospital as Thunder the mini pig flopped onto his side and the children huddled around him, scratching his pink, hairy belly. He and his wet-nosed partner, Bolt, drew patients in wheelchairs and bandage...
Published: 12/15/17
Obamacare enrollment ends today, but some can get an extension

Obamacare enrollment ends today, but some can get an extension

Today is the day that open enrollment for the Affordable Care Act will close for most people. But those affected by the slew of hurricanes that pummelled Florida, Texas, Puerto Rico and other states earlier this year can take advantage of a two-week ...
Published: 12/15/17
City Council sinks deal to alter ownership of Bayfront Health St. Petersburg

City Council sinks deal to alter ownership of Bayfront Health St. Petersburg

ST. PETERSBURG — After months of tense negotiations and weeks of political impasse, the City Council on Thursday derailed a proposal that would have changed the ownership structure of the city’s largest hospital, Bayfront Health St. Petersburg.The 5-...
Published: 12/14/17
Florida hospitals call for more funding in effort to address looming doctor shortage

Florida hospitals call for more funding in effort to address looming doctor shortage

The number of doctors practicing in Florida has not kept up with the state’s surging population growth, and more money is needed to recruit and keep them here, hospital leaders said Wednesday.The shortage is particularly acute in four speciality area...
Published: 12/13/17
An overlooked epidemic: Older Americans taking too many unneeded drugs

An overlooked epidemic: Older Americans taking too many unneeded drugs

Consider it America’s other prescription drug epidemic.For decades, experts have warned that older Americans are taking too many unnecessary drugs, often prescribed by multiple doctors, for dubious or unknown reasons. Researchers estimate that 25 per...
Published: 12/13/17
How is Florida’s health? Not so great, report says

How is Florida’s health? Not so great, report says

Florida slightly improved its national standing this year, rising from 36th to 32nd overall in the annual America’s Health Rankings report. But the takeaway for the nation’s third-largest state is that it has a long way to go in many important health...
Published: 12/12/17
Driven by demand, Planned Parenthood opens second clinic in Tampa

Driven by demand, Planned Parenthood opens second clinic in Tampa

The floor-to-ceiling glass windows are heavily tinted and the inside is hidden behind rows of curtains. Security cameras monitor every corner, and only patients with an appointment and valid identification can pass through the intentionally cramped e...
Published: 12/12/17
Video: Jimmy Kimmel holds his baby son, post-heart surgery, in emotional health-care monologue

Video: Jimmy Kimmel holds his baby son, post-heart surgery, in emotional health-care monologue

Jimmy Kimmel was absent from his ABC late-night show last week while his 8-month-old son, Billy, recovered from his second heart surgery. Ever since Billy was born with a heart defect and required immediate surgery, Kimmel has become an outspoken adv...
Published: 12/12/17
Record numbers are signing up for Obamacare in Florida as enrollment period draws to a close

Record numbers are signing up for Obamacare in Florida as enrollment period draws to a close

With just four days left to enroll for health insurance on the federal exchange, advocates for the Affordable Care Act say Florida is headed for a record-breaking year. In week five of the six-week open enrollment period, about 823,180 people signed ...
Published: 12/12/17
A boy shares the pain of being bullied - inspiring thousands to show him love (w/video)

A boy shares the pain of being bullied - inspiring thousands to show him love (w/video)

While fighting back tears, young Keaton Jones couldn’t stop asking one question: Why?"Just out of curiosity, why do they bully? What’s the point of it?" he asks his mother while in the passenger seat of a parked car. "Why do you find joy in taking in...
Published: 12/10/17
Updated: 12/11/17