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06 February 2019
The debate over prescription drug copay coupons continues to rage between pharmaceutical and insurance companies. While pharmaceutical companies offer brand copay coupons as a tool to offset patient out-of-pocket costs for name-brand drugs, insurance companies encourage the use of lower-cost generic medications as the right strategy for addressing spiraling prescription drug prices.
Providers and patients often find themselves caught in the middle. And unfortunately, in tandem with the ongoing debate, the reality on the frontlines of care delivery is that patients need help affording their medications.
The shift toward value-based care demands greater industry collaboration to bridge the healthcare gap and cut expenses without sacrificing quality. Medication affordability is a big part of this equation. When the right data-sharing and connectivity framework exists, pharmaceutical companies and providers can essentially work together to become patient advocates, empowering healthcare’s most important asset with resources for lowering costs and improving overall health in a sustainable way.
Medication Adherence: Challenges and Opportunities
Patients currently struggle under a trifecta of challenges: higher copays, a shrinking pool of generic alternatives, and high-deductible health plans.
The Kaiser Family Foundation reports that, during the 10-year span between 2005 and 2015, the average medical costs for covered workers rose 66 percent, while wages grew only 31 percent. It’s worth noting, too, that the increased costs weren’t limited to only patients: the average payment by health plans rose 56 percent over that same time period.
As patient costs continue to rise, many patients find themselves actively seeking ways to control their healthcare costs. In some cases, this equates to medication non-adherence.
Notably, it’s also well documented that lowering a patient’s out-of-pocket costs can improve follow-through with medication therapies—a significant industry challenge—and patient outcomes. Consequently, medication affordability strategies can have significant impact on healthcare costs related to poor outcomes and disease progression, which one 2013 study estimated to be between $100 billion and $300 billion annually.