Copay Assistance for Expensive Drugs: A Helping Hand That Raises Costs

Ideas and Opinions20 December 2016Copay Assistance for Expensive Drugs: A Helping Hand That Raises CostsPeter A. Ubel, MD and Peter B. Bach, MDPeter A. Ubel, MDFrom Duke University, Durham, North Carolina, and Memorial Sloan Kettering Cancer Center, New York, New York. and Peter B. Bach, MDFrom Duke University, Durham, North Carolina, and Memorial Sloan Kettering Cancer Center, New York, New York.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M16-1334 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail After members of Congress and the public expressed outrage at Mylan over its 8-year 600% price increase for the EpiPen, the company proposed a seemingly helpful solution: It offered patients coupons worth up to $300 to cover part of their out-of-pocket costs (1). Such copay assistance seems like a boon for public health, but it is actually a recipe for higher health care costs in the future.In recent years, drug spending has been one of the fastest growing sectors of health care (2). The amount patients pay out-of-pocket for drugs has also grown rapidly (3). The 2 are related: ...References1. Pollack A. Mylan to offer some patients aid on cost of EpiPens. New York Times:B4. 25 August 2016. Accessed at www.nytimes.com/2016/08/26/business/epipen-mylan-price.html?_r=0 on 21 September 2016. Google Scholar2. CSHS health sector economic indicators briefs. Ann Arbor: Altarum Institute; 2016. Accessed at http://altarum.org/our-work/cshs-health-sector-economic-indicators-briefs on 9 September 2016. Google Scholar3. NHE fact sheet. Baltimore: Centers for Medicare & Medicaid; 2016. Accessed at www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/nationalhealthexpenddata/nhe-fact-sheet.html 9 September 2016. Google Scholar4. Ross JS, Kesselheim AS. Prescription-drug coupons—no such thing as a free lunch. N Engl J Med. 2013;369:1188-9. [PMID: 23984672] doi:10.1056/NEJMp1301993 CrossrefMedlineGoogle Scholar5. The 2016 Pulitzer Prize finalist in explanatory reporting: finalist: Jonathan D. Rockoff, Joseph Walker, Jeanne Whalen, Peter Loftus and Ed Silverman of The Wall Street Journal. New York: The Pulitzer Prizes; 2016. Google Scholar6. Bach PB, Saltz LB, Wittes RE. In cancer care, cost matters. New York Times:A25. 15 October 14. Accessed at www.nytimes.com/2012/10/15/opinion/a-hospital-says-no-to-an-11000-a-month-cancer-drug.html on 21 September 2016. Google Scholar7. Pollack A. Coupons for patients, but higher bills for insurers. New York Times:BU1. 1 January 2016. Accessed at www.nytimes.com/2011/01/02/business/02coupon.html on 21 September 2016. Google Scholar8. Goodman JC. Consumer directed health care. Networks Financial Institute policy brief no. 2006-PB-20. Indianapolis: Networks Financial Institute at Indiana State University; 2006. Accessed at http://papers.ssrn.com/sol3/papers.cfm?abstract_id=985572 on 21 September 2016. Google Scholar9. Pearson SD, Bach PB. How Medicare could use comparative effectiveness research in deciding on new coverage and reimbursement. Health Aff (Millwood). 2010;29:1796-804. [PMID: 20921478] doi:10.1377/hlthaff.2010.0623 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Duke University, Durham, North Carolina, and Memorial Sloan Kettering Cancer Center, New York, New York.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M16-1334.Corresponding Author: Peter Ubel, MD, Duke-Margolis Center for Health Policy, Duke University, 100 Fuqua Drive, Durham, NC 27708; e-mail, peter.[email protected]edu.Current Author Addresses: Dr. Ubel: Duke-Margolis Center for Health Policy, Duke University, 100 Fuqua Drive, Durham, NC 27708.Dr. Bach: Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065.Author Contributions: Conception and design: P.A. Ubel, P.B. Bach.Analysis and interpretation of the data: P.A. Ubel, P.B. Bach.Drafting of the article: P.B. Bach.Critical revision of the article for important intellectual content: P.A. Ubel.Final approval of the article: P.A. Ubel, P.B. Bach.Provision of study materials or patients: P.A. Ubel.Statistical expertise: P.A. Ubel.Obtaining of funding: P.A. Ubel.Administrative, technical, or logistic support: P.A. Ubel.Collection and assembly of data: P.A. Ubel, P.B. Bach.This article was published at www.annals.org on 11 October 2016. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byMobile Application to Identify Cancer Treatment–Related Financial Assistance: Results of a Randomized Controlled TrialCostly savings: An ethical analysis of copay assistance programs in dermatologyOphthalmic Medication Expenditures and Out-of-Pocket SpendingPatient and Provider Variables Associated with Systemic Treatment of Advanced Prostate CancerMedical Marketing in the United States, 1997-2016Use of Charity Financial Assistance for Novel Oral Anticancer AgentsThe financial burden and distress of patients with cancer: Understanding and stepping-up action on the financial toxicity of cancer treatmentFinancial ToxicityMedication Access in America and Medicare Part D: Prescription Shopping Saves but May Be CostlyASCO Value Framework Highlights the Relative Value of Treatment Options in Ovarian CancerReducing Branded Prescription Drug Prices: A Review of Policy OptionsAssociation of Reference Pricing with Drug Selection and SpendingAddressing the challenge of high-priced prescription drugs in the era of precision medicine: A systematic review of drug life cycles, therapeutic drug markets and regulatory frameworksRising Prices of Targeted Oral Anticancer Medications and Associated Financial Burden on Medicare BeneficiariesPatient Financial Assistance Programs: A Path to Affordability or a Barrier to Accessible Cancer Care?The Role of Patient Financial Assistance Programs in Reducing Costs for Cancer PatientsCopay assistance programs lead to higher healthcare costs 20 December 2016Volume 165, Issue 12Page: 878-879KeywordsDisclosureDrug policyDrug pricesDrugsForecastingHealth careHealth care sectorHealth care utilizationPatientsPrevention, policy, and public health ePublished: 11 October 2016 Issue Published: 20 December 2016 Copyright & PermissionsCopyright © 2016 by American College of Physicians. 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