Last month Drug Benefit News ran a story on PBM and insurer tactics to combat the growing use of copay cards among members. As you may already know, these copay offset programs are loathed by PBMs for their potential to undermine tiered benefit designs and increase overall cost share.
Mason Tenaglia, managing director of pharmaceutical strategy consulting firm The Amundsen Group, voiced his skepticism over the so-called dangers of copay cards in that piece and has just published a lengthy defense of these programs in the January issue of Pharmaceutical Executive. In a nutshell, Tenaglia uses data gathered by his firm to argue that these coupons are not steering patients away from less expensive drugs they could be or are already taking but are actually increasing adherence to needed medications.
One of the problems insurers and PBMs have with these cards is that they can’t track who is using them and identify the therapeutic classes in which they’re driving cost. Tenaglia’s firm, meanwhile, has access to both redemption data sent to its clients by way of offset program vendors such as McKesson Corp. and Cegedim Relationship Management, as well as Anonymous Patient Longitudinal Data licensed to its clients by Wolters Kluwer in more than 30 retail and specialty therapeutic markets. This intelligence enables the company to determine whether a patient who used a copay card was new to therapy, switched from a competing brand or generic, or was a continuing patient — all findings that could be of use to a PBM or health plan.
Tenaglia uses the data to make the following claims: (1) Copay cards do not actually lead to lower generic utilization in any of the major therapeutic classes, (2) they are frequently used by patients already taking the least expensive brands (Tier 2 prescriptions), (3) most of the dollars spent by U.S. pharmaceutical companies on copay offset programs are for specialty and biologic therapies, and (4) these programs lead to higher adherence to drugs that have already been chosen by the physician and the patient (thus keeping down hospitalization and annual medical costs).
Do the above claims alter your view on copay offset programs?
It's quick and easy to sign up!
Featured Pharmacy Benefit Management Products
Atlantic Information Services, Inc. - 1100 17th Street NW, Suite 300, Washington, DC 20036 - 800-521-4323
Copyright © 2012 Atlantic Information Services, Inc. All Rights Reserved.
