Drugmaker copay coupons increase prescription drug costs | Pharmacy benefit managers provide solutions to address the opioid crisis | HHS plan to cut drug spending projected to have low economic impact on industry
Drugmakers' copay coupons increase demand for branded drugs instead of less costly generic versions or other alternatives, ultimately resulting in higher insurance premiums for everyone, writes William Schiffbauer. "This practice could be characterized as 'tortious interference' with health insurance contracts that is deliberately intended to 'disable' the cost-sharing terms and conditions in health plan formularies designed to encourage lower-cost alternatives," Schiffbauer writes. "In effect, the sponsoring pharmaceutical manufacturer is operating as an unauthorized insurance entity," he adds.
The plan submitted by HHS to the Office of Management and Budget to reduce drug prices and out-of-pocket costs would cost the government or industry less than $100 million, says John Leppard of Washington Analysis.
Sen. Claire McCaskill, D-Mo., said none of the Republicans she has approached agreed to support legislation to repeal a 2016 law that critics say impedes the Drug Enforcement Administration's authority to halt suspicious shipments of prescription opioids.
A group of senators led by Sen. Debbie Stabenow, D-Mich., sent a letter to HHS Secretary Alex Azar urging the agency to negotiate a cheaper price for naloxone, an opioid overdose reversal drug. "By bringing down the cost, we can get this life-saving drug in the hands of more people as called for by the Surgeon General. Doing so will save countless lives," the senators wrote.
A bill that would let Affordable Care Act customers and employers buy Medicare coverage was unveiled Wednesday by Sens. Jeff Merkley, D-Ore., and Chris Murphy, D-Conn. The legislation, which is co-sponsored by 10 Senate Democrats, would also permit the government to negotiate Medicare drug prices and extend eligibility for ACA subsidies to 600% of federal poverty level.
Drugmakers' copay coupons may benefit specific patients in the short term, but the coupons ultimately drive up prescription drug prices and cost employers and health plan sponsors, says Express Scripts Chief Medical Officer Steve Miller.
PCMA is the national association representing America's pharmacy benefit managers (PBMs), which administer prescription drug plans for more than 266 million Americans with health coverage provided through Fortune 500 employers, health insurance plans, labor unions, and Medicare Part D. PCMA is dedicated to enhancing the proven tools and techniques pioneered by PBMs that generate savings and access for consumers and payors.
Contact PCMA Charles Cote
Vice President, Strategic Communications