Few topics tend to raise more heated debate than the economics surrounding drug prices, copays and discounts. Pharmacists are frustrated, and rightly so, as drugstore chains have raced to the bottom – pricing prescriptions at or below cost just to get patients in the door. The consequence has been smaller and smaller margins forcing pharmacies to fill faster and faster to make a profit. Prescribers often tire of the games played by drug manufacturers to extend patents and delay generics entering the market that would otherwise make needful drugs more affordable.
But maybe no one is more frustrated than patients who frequently find themselves faced with larger and larger copays, cutting deeply into their budgets and leaving them puzzled about how to afford the medication they need. As a pharmacist this really concerns me.
This post is about 1 specific tool that pharmacists and pharmacies can use to help reduce copays and save some patients thousands of dollars every year. Patients can also utilize this approach to do the research on their own before going to the pharmacy.
What I’m talking about are Prescription Drug Coupons.
WHAT ARE PRESCRIPTION DRUG COUPONS?
Prescription Drug Coupons are coupons offered by the manufacturer of selected brand-name drugs which typically function in 1 of 2 ways:
1) Sometimes these coupons are good for a FREE 1-time supply of the specific medication. This supply may be for a week, a month or a single unit (like 1 free inhaler). For example, right now the makers of Cialis are offering a FREE trial of their product through enrollment in their online prescription coupon program. Find that offer HERE.
2) Most often these coupons help reduce patient copays by paying for a portion of the patient’s copay. For example, a coupon may reduce a patient’s $100 monthly copay down to $25 by contributing $75 from the manufacturer. Some coupons promise to lower any copay to a specified amount ($15 for example) by covering anything over that amount. Typically these coupons are good for a specified number of fills (6 months or 1 year for example).
By the way – Prescription Drug Coupons are NOT the same thing as a Prescription DISCOUNT card. Discount cards (which are free and work for ANY drug )are something altogether different. For more information on prescription discount cards check out my article HERE.
HOW ARE THESE PRESCRIPTION DRUG COUPONS USED?
Pharmacies treat these coupons virtually like insurance cards. They process the same way an insurance card processes. Often they are used AFTER the patient’s primary insurance is billed. This process is typically referred to as a “split bill” in which a primary insurance is billed first, and any remaining copay is then billed to the coupon in order to obtain the additional discounts.
Prescription drug coupons will have a BIN number, PCN number, Group number and ID number – just like a prescription insurance card. If you have been handed one by your doctor, bring it with you to the pharmacy as they will need these numbers to process it.
ARE THERE RESTRICTIONS ON USING THESE CARDS?
There are some restrictions on the use of these cards. For example, many cannot be used in conjunction with any Federal or State subsidized insurance. (i.e. Medicaid or Medicare Part D). States may have regulations or restrictions surrounding the use of these cards. Some of these cards require that a patient have some sort of primary insurance to begin with.
WHERE DO YOU FIND THESE CARDS?
Prescription drug coupons are sometimes obtained at your doctor’s office. Many times drug sales specialists will leave these coupons with doctors in hopes that they will prescribe their product. Pharmacies also sometimes keep a supply of these cards. In my pharmacy we keep them next to the drug on the shelf.
But the easiest way to find these coupons is online. I recommend using 1 of the following 3 methods to find such coupons online:
1) Check out Internet Drug Coupons. This website collects information from hundreds of drug websites and conveniently organizes them for you.
2) Check out a similar site maintained by Pharmacy Times. Pick whether you are a patient or pharmacist and then use the convenient search box or alpha list to find your drug.
3) Just go directly to the prescription drug website. Generally, if you type in the name of your prescription drug into a search engine like Google, you will be shown the url for the drug’s website in the top listing. Go there and look around the home page for savings offers and coupons.
NOTE: These cards are typically only offered for brand-name drugs. Most often they are offered by manufacturers of drugs for which SOME alternative therapy exists. The coupons are one marketing tool used by the manufacturer to help set their product apart from an otherwise equivalent competitor.
THE ISSUES AND CONTROVERSY
Prescription discount cards are the subject of some degree of controversy. Insurance companies generally don’t like them because they significantly reduce the patient copay, thus making it less likely the patient will inquire about a less expensive generic. Copays, we need to remember, are the tool that insurance plans use to limit unnecessary utilization of medications. The cheaper the copay, the less likely it is that a patient will look for alternatives.
Some pharmacies and pharmacists don’t like them because they view them as a time-consuming bother, and sometimes the billing process can create a complicated mess.
Physicians are sometimes skeptical because they realize that eventually these coupons will run out, thereby exposing the patient once again to a potentially expensive copay which they cannot afford and therefore may not pickup their medications at all.
As a pharmacist, I believe that the incentives needed to keep pushing drug research for more cures and better treatments means that we will all have to bear some of the cost of expensive brand-name drugs. But competition between competing brands works in the favor of patients and may result in the availability of prescription drug coupons with substantial savings.
I personally use these coupons, seek them out, and offer them to patients whenever I can. The fact that certain aspects of our healthcare system frustrate me does not blind me to the simple fact that saving $25 or $50 or $100 per month is a BIG deal for most of my patients.
Have you personally ever used these coupon cards? Do you have any questions or comments about them? Feel free to reply below. I would love to hear from you.
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