Pharmaceutical manufacturers have scored two recent wins related to their increasing use of discount coupons for branded drugs.
First, they will be allowed to offer the coupons to those enrolling in the new marketplaces. Second, a new study is one of the first to link coupon use to higher drug adherence, in this case, for patients using statins.
While I'll leave the details of the ruling concerning the new marketplaces to my colleague Sheri Sellmeyer, suffice it to say it's a huge win for pharma, but not for health plans and pharmacy benefit managers who believe the coupons often undermine their attempts to manage pharma benefits through copay tiering.
While PBMs and health plans can make a business case for controlling the use of copay coupons, consumers have typically sided with pharma in the fight. After all, consumers have been accepting more and more of the burden lately of paying for drugs and medical services via high deductibles, coinsurance and deductibles specific to branded drugs.
A new study from the Journal of Managed Care Pharmacy finds a group of patients on branded statins who also used copay coupons had higher adherence during the first year of therapy compared to those statin patients not using coupons, or to those using generic statins. This study represents the most rigorous evidence to date regarding the impacts of coupons on medication adherence and costs based on a large cohort of users, according to the article in the November/December issue of the journal.
The study used commercially available claims data over three years representing more than 340,000 patients. It compared demographics, statin use and expenditures for patients starting generic or branded statins without coupons and branded statins with coupons.
While the study is significant in finding greater adherence (61.1 percent adherence for branded + coupons, versus 60.1 percent for those using generics and 53.8 percent for branded + no coupons), it also found that coupon users had higher costs than generic and non-coupon users. The total annual costs for coupon users was on average $798, versus $92 for generic and $678 for non-coupon users.
The adherence data is encouraging and may give pharma a positive message around the coupons. But the disparity between branded and generic statin cost is vast, even with the help of coupons. As we move toward more patient out-of-pocket shares via exchanges, that's the message that may be hard to ignore.
Follow Jane DuBose on Twitter @JaneGDuBoseHLI