Last month, the cover of BusinessWeek featured an article, How Big Pharma Uses Charity Programs to Cover for Drug Price Hikes, focused on co-pay charities for Medicare patients. I of course had heard about such co-pay charities before, and even had the opportunity to meet with a representative of one a few years ago, but frankly I had no idea what they did. So when the article came out, outlining the “evils” of this practice, it caught my attention. By catching my attention, it actually saved my elderly parents significant amounts of money.
My father and mother are both retired, living on a small pension and Social Security. Both have high LDL cholesterol and have had serious reactions to statins, a drug used for treating cholesterol. Statins are one of the most effective therapies in treating high LDL cholesterol. My parents had tried every statin, except one: Lavalo (pitivastatin). When they eventually went on that statin, they did not see the side effects they had seen while taking others in that class. The only problem is that pitvistatin is still branded and comes with a significant co-pay, somewhere around $200/month.
My father has also had reactions to Coumadin, an older blood thinner with a long list of restrictions, including not eating dark green vegetables such as lettuce, kale, and spinach. If my father were still ten years old, such a restriction may not be a problem; however, he loves eating salad and actually likes broccoli. Being on Coumadin also requires monthly checks of his blood called INR. If INR goes awry, then one can end up in the emergency room. While there are alternatives to Coumadin, it is branded and costs significantly more, with a much higher co-pay. For the last three years, my father has taken the alternative to Coumadin and it has worked effectively with no worries about his diet.
More recently, ProPublica’s Charles Ornstein has penned a joint article in the Washington Post, Are Copay Coupons Actually Making Drugs More Expensive?.
In this article, Charles outlines drug discounts and his experience with such discounts. The article helps to show his dilemma, as not all drugs can be replaced with a generic, and co-pays for branded drugs are expensive.
Though he thinks co-pay coupons add costs to the system, there is something to be said for saving funds of people who can’t afford the medications they need – medications with fewer side effects and/or better effectiveness – to be able to afford those medications. In the end, the two people referenced in Charles’ article (his son and his friend) both benefited from access to co-pay coupons.
Insurance companies and government payers would love it if physicians were to only write prescriptions for generic drugs. They regularly laud the benefits of these drugs while downplaying the many side effects. The dilemma is this: creating new, more effective, drugs with fewer side effects is expensive and requires a significant amount of trial and error. On the other hand, pricing the drugs is tricky when companies have to consider discounts, copays, and rebates.
In our family, we use several branded medications and until Charles’ article, it had never dawned on us to use coupons. Recently, after reading the article in BusinessWeek, I went online with my parents to find co-payment charities for the expensive, but effective, drugs they are taking. Thankfully, those few minutes we spent online has saved both of my parents significant amounts of money. If it were not for those “negative articles,” we would have never known. So from now on, our household can be considered “coupon shoppers” if we receive a branded prescription.
In the end, both articles brought attention to various ways industry is helping to pay for medication. For that, I am forever grateful.