So, while employers and payors are looking for ways to save money by more aggressively promoting utilization management and generics, the manufacturers are looking for ways to maintain market share even as patents expire. You combine that with a continued rise in consumerism and online health activities and it creates a new channel for manufacturers. While they were traditionally limited in their ability to get “samples” into the hands of consumers and know who those consumers are, coupons change that. And, finally with the stretched consumer, any savings can look attractive especially things that allow them to get credit towards their deductible, but save money.
This has driven the rise of online couponing sites and you see companies like AARP and others promoting them. Most people don’t fully appreciate the fact that the coupons are primarily offered on drugs with generic equivalents or in highly competitive classes where the payor cost is likely going up as the consumer stays on or shifts to the couponed drug. And, if you don’t know, typically manufacturers will rapidly increase the price of their drug once the patent expires or even before that to make as much money as possible off those that stay on the medication.
There are probably a few exceptions, but in general, coupons are focused on chronic medications that are either: New to market Off formulary (i.e., non-preferred) In highly competitive categories Or are specialty drugs where the member’s contribution could be significant
If I’m a manufacturer, coupons are much preferred to samples. They only incur product costs when the coupon is used. The member has to “register” to receive the coupon giving them patient information. They should allow them to maintain or gain marketshare. And, the big question is whether they drive adherence and therefore have some relevant health outcome.
Here’s an example of one of the sites out there. As you can see, there are links to dozens of coupons here. You can print coupons from the page. As you can see on the next page (turn slide)
So, how should payors respond to non-specialty medications…
Health Plans vs. Drugmakers: The Battle Over Copay Subsidies November 5, 2009 George Van Antwerp, GM, Silverlink Communications