Use of manufacturer-sponsored coupons for brand-name drugs declined among commercially insured patients between 2017 and 2024, even as the value of coupon offsets increased, according to a study published April 6 in JAMA.
The study analyzed pharmacy claims data from 3,243,061 commercially insured patients covering 55,325,139 claims for brand-name drugs without generic competition.
The findings come as alternative drug purchasing and pricing models continue to expand, giving patients and health systems another channel to access brand-name and generic drugs at transparent prices without relying on manufacturer incentives. The Trump administration launched TrumpRx.gov in February, which now lists over 50 discounted brand-name drugs tied to most-favored-nation pricing agreements. Mark Cuban Cost Plus Drug Co. has also expanded its direct-pay pharmacy and wholesale operations.
Here are four things to know from the study:
- Patient-level coupon use fell from 18.0% in 2017 to 13.9% in 2024, while the percentage of pharmacy claims covered by coupons per patient declined from 13.7% to 7.6%.
- Coupon use for obesity therapies dropped from 54.6% in 2017 to 2.5% in 2024, and diabetes therapy coupon use declined from 20.8% to 8.3%, largely tied to GLP-1 receptor agonists. Coupon use for immunomodulators increased from 4.2% to 23.8% over the same period.
- Despite lower utilization, median coupon amounts per pharmacy claim increased from $60 in 2017 to $90 in 2024. Median patient out-of-pocket spending after coupon offsets remained stable at $10.
- Researchers said the trends may reflect manufacturers concentrating coupon programs on fewer drugs or patients while increasing incentives in response to formulary restrictions and copay accumulator programs.
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