OIG: Crack down on Medicare co-pay cards

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Co-pay cards are finding their way into Part D Medicare coverage, and the Office of Inspector General says in a recent report that more needs to be done to keep out these branded-drug discounts. The OIG notes that although manufacturer coupons do have notes to consumers and/or pharmacists that say they cannot be used by beneficiaries of a federal healthcare plan (like Medicare), the printed notices are clearly not working, since between 6% and 7% of seniors have been using these cards in exchange for lower co-payments.

OIG's concern is the same one that has been kicking around for a while, which is that the lower co-payment may translate into higher downstream costs for the Part D plans because the coupons subvert the system that is in place to keep costs down by having patients gravitate towards lower-priced medications (as in lower for the insurer, not just the patient).

The OIG's recommendations include working with stakeholders to find a way to give the don't-use warnings a little more oomph, since the printed word doesn't seem to be working, and back-of-the house controls are still letting too many coupons go through.

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