Pharmacy Benefit Managers for Top U.S. Employers Disallow Drug Coupons

Discount cards issued by drugmakers to patients often keep patients filling pricey prescriptions and prevent them from discontinuing expensive branded drugs or switching to less costly alternatives.  While drug manufacturers have claimed these discount card programs help lower-income patients afford medicines that they might not otherwise be able to obtain due to high copayments or other cost-sharing provisions, the use of these cards ultimately drives up health plan costs. Pharmacy benefit managers for two top U.S. employers – Walmart and Home Depot – are exploring ways to negate the effects of discount cards and incentivize patients to seek less expensive treatments.

The companies have established programs, run by CVS Health and Express Scripts, known as copay accumulators (which prevent money spent using a discount card from applying to annual out-of-pocket spending) and copay maximizers (which raise copays for patients using coupons).

These programs are expected to expand in the next two years and may soon affect as many as 50 percent of employer health plans. Pharmaceutical representatives who spoke to Reuters predict the initial impact will be minimal, but they are monitoring the situation closely.

Source: Reuters, November 13, 2018.