Nov 23, 2011

Copay cards - follow the money

Co-pay cards are an often used tactic to encourage patients to try a new branded medication that is prescribed by their physician, eliminating the concern for an expensive co-payment that can come with a Tier 3 drug. In CRM terms, they are used as a conversion tactic, and can even be the gateway to an adherence program.

Here is another perspective on co-pay cards:

In a very interesting article and interview in MMM, the Pharmaceutical Care Management Association is cited in an estimation of how much additional cost must be reimbursed because of the use of copay cards: $32 billion over the next ten years. In addition, the PCMA clarifies who is paying for those costs: employers, unions, and state employee plans. As well as taxpayers.

In other words, someone has to pay the insurance companies the money they expected in their copayments. Some is borne by the phramaceutical manufacturers, but some is also paid for by those who contractwith the insurers, like employers et al. The details of this analysis are not crystal clear, but it most likley is based on the missed savings that would come from generic usage. In any regard, this is a thought provoking total.

Want to read more about the perspective of the PCMA?: Browse their website, or a research report (by Visante) about their planned drug cost savings over the next 10 years.