Community Catalyst has declared war on prescription co-pay cards and coupons, calling the sales tools nothing more than kickbacks and bribes.
The consumer advocacy group filed suit in four states seeking to ban coupons and co-pay cards, noting that Medicare and Medicaid programs ban them. The lawsuits are on behalf of the group's members, which include the AFSCME District Council 37 Health & Security Plan Trust and the Plumber and Pipefitters Local 572 Health and Welfare Fund. The suits cite Pfizer, Amgen, AstraZeneca, Bristol-Myers Squibb and Novartis, GlaxoSmithKline and Abbott Labs. Community Catalyst's staff attorney Wells Wilkinson says lawsuits were filed in cities near the headquarters of the companies named in the suits.
Co-pay cards have long been an industry presence. The issue, Wilkinson said, is their growth and the role they play in inducing patients to opt for name-brand prescriptions. The organization's press release about the lawsuit cites a November report for the Pharmaceutical Care Management Association which claims these cards will increase costs by $32 billion over the next ten years. The study adds that if coupon use goes unabated for the next decade, prescription costs could jump by $2.6 billion in Texas, $2.3 billion in New York, and $2.5 billion in California.
PCMA's report says the programs give pharma a six-to-one return on investment and that more than 50% of coupon users stayed with the name-brand drugs for almost a year after a generic version hit the market.
The release claims these costs are increasing the financial burden for employers and their healthcare companies. An IMS Health report for the New York Times showed coupons, discounts and co-pay cards tripled between mid-2006 and 2011.
Wilkinson told MM&M that the PCMA report “was the first kind of public cry of alarm” about the impact these programs have on consumer behavior, which, in turn, drives up costs for employers whose plans end up footing the bill for higher-tier drugs.
But cost may be a matter of perspective. “Co-pay cards are a proven way to improve adherence,” Peter Frishauf, of research group Crossix, told MM&M. “That is both a value to the pharmaceutical industry and a very effective way of lowering overall healthcare costs.”
Trade group PhRMA could not comment on the lawsuit, but said in a statement that discount programs “play a valuable role in increasing access to medicines and improving patient adherence to prescribed therapies, generating better health outcomes and reducing the use of avoidable and costly medical care.”
Although outright bans on branded drugs could be a tactic for employer health plans, Community Catalyst's Wilkinson said such an approach would be extreme and detrimental.
“There could always be a few people who do not respond to one medication and should try another,” he said, adding that the preference would be for “the decision to use the drug to be based on a medical decision by a doctor and not be promoted by the marketing that goes into these drug products.”