May 3

Jayne O’Donnell

Drug maker-funded coupons and patient assistance programs are proving to be an uncertain and often questionable way for patients to afford what a new report shows are increasingly expensive specialty and other brand name drugs.

Cumulative spending on drugs that are still under patent is rising at an average annual rate that’s more than double the rate of increase in spending for all drugs and was up 285% between 2010 to 2016, according to a report out Wednesday by the Blue Cross Blue Shield Association (BCBSA). During the same period, overall spending on brand name and generic drugs with competition dropped by 47%, the analysis of 30 million BSBSA commercial insurance claims showed.

Patients and advocates say co-pay assistance enhances the drug maker’s public image while it obscures their high prices. One patient advocate says the companies can often write off their assistance on their taxes, which gives them another financial benefit.

“Coupons are interesting,” says BCBSA chief strategy officer Maureen Sullivan. “On one hand, it sounds good because it’s cheaper, but they could drive someone to a drug that increases costs overall and provides little clinical value.”

Co-pay assistance offsets these costs for a growing number of patients, according to research by QuintilesIMS Institute, which found the percentage of prescriptions filled using a coupon increased from 13% to 17% between 2013 and 2015. The institute’s 2016 US Medicines report will be released Thursday.

By limiting a patient’s out-of-pocket costs for drugs, drug companies steer patients to more expensive drugs that may not work better than lower-cost brand name or generic competitors, pharmacists and drug pricing experts say. That also thwarts the most effective tool insurers have to control drug costs. After commercially insured patients meet their deductibles or out-of-pocket premiums, the insurers pay the higher drug costs, which get passed along in higher premiums.