The Hidden Costs of Prescription Drug Coupons and Discount Cards

by pharmacy on November 21, 2012

The Hidden Costs of Prescription Drug Coupons and Discount Cards

With health care costs soaring, patients are looking for any way they can to save money on prescriptions. And who can blame them? Let’s look at Effexor XR, for example, an antidepressant. The average monthly prescription cost for a single daily dose of Effexor XR 150 mg is about $193, and the average monthly cost of the same dosage of generic venlafaxine sustained released is about $129. The generic cost is still a considerable amount for the average American. Pfizer offers a $4 prescription co-pay discount, which provides a substantial savings to the patient… but at what expense?

The patient only has to come up with $4 a month for the Effexor XR, but it costs $193. Who’s going to make up the difference? The insurance companies. They don’t do this out of the goodness of their hearts, either. When their costs increase, they respond with an increase in insurance premiums…which means that patients end up paying the price in the end anyways. And sometimes this still happens when a suitable, and much more economical, generic form of the drug is available. A doctor in New Hampshire describes how patients request Lipitor, available for $4 with a Web coupon, when generic simvastin is available for a $10 co-pay…and Lipitor costs $1,400 more per year for the insurer, at a savings of only $72 for the patient. The doctor also notes that these drug coupons could end up increasing prescription drug spending by $32 billion over the next decade. Yikes!

Aside from rising premiums, dependence on drug discount cards and coupons comes with another price… what happens to patients when the programs are discontinued. Pharmaceutical companies can place restrictions on their discount programs and discontinue them at any time. If a generic form of the drug is not available, the patient gets stuck paying full price for the brand name drug. Some patients don’t even ask their doctors if a generic is available, and they may end up sticking with the brand name drug (with its higher price tag) simply because they don’t know any better. This can wreak havoc on a patient’s finances, and it could encourage noncompliance with a prescription regimen that had been working well for them.

Physicians should talk to their patients about the real cost of these drug discounts, but pharmacists can help, too. If you notice that customers are filling prescriptions for expensive brand name drugs, you can let them know when an inexpensive generic is available. It’s not a pharmacist’s place to explain the economics of the drug discount coupons, but simply letting a customer know that an affordable alternative is available can be helpful, especially when the customer forgets a coupon or complains that the discount program ended.

How do you educate customers about prescription drug costs? Have you ever had a negative reaction from a customer when mentioning generic drugs?

{ 2 comments… read them below or add one }

Jim Jameson December 17, 2012 at 4:59 pm

The part about insurance companies picking up the cost seems misleading to me. Insurance companies have no motive to do that, so I don’t believe that part. The cost is absorbed by the drug companies, who presumably make it up when they discontinue the program (as mentioned in the article) or possibly from other patients.

Insurance companies are only involved indirectly, in that they pay for all drugs. Even then, most insurance companies charge extra for brands, or even refuse coverage, so the distribution of the cost is much less clear than the article seems to imply.

Bibiana July 13, 2013 at 5:11 am

I do not know about the Effexor copay, but I will say this: Walgreens has a very good prescription program for patients who are not on Medicare/Medicaid. You pay $20 a year, and you get reductions as high as 75%. It has been a godsend for me.

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