Copay coupons are exacerbating drug price inflation, economists say

Drug copay coupons offer patients savings on prescriptions, but they significantly increase amounts paid by insurers and employers, according to a study published by National Bureau of Economic Research.

Three economists analyzed data on net-of-rebate prices and quantities from a large pharmacy benefits manager. They found drug copay coupons increased quantities sold by 21-23 percent for the commercial segment relative to Medicare Advantage in the year after they were introduced, but they do not affect net-of-rebate prices.

The research team estimated coupons raise negotiated prices by 8 percent and result in about $1 billion in increased U.S. healthcare spending annually — just for multiple sclerosis drugs.

"Our results suggest that popular policy proposals such as capping cost-sharing or requiring plans to shift from coinsurance to fixed (and low) copays are likely to lead to drug price inflation," the economists wrote. "These reforms would likely exacerbate the underlying problem of high prices while addressing a symptom (high patient cost-sharing)."

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