TY - JOUR
T1 - Specialty drug coupons lower out-of-pocket costs and may improve adherence at the risk of increasing premiums
AU - Starner, Catherine I.
AU - Alexander, G. Caleb
AU - Bowen, Kevin
AU - Qiu, Yang
AU - Wickersham, Peter J.
AU - Gleason, Patrick P.
N1 - Publisher Copyright:
© 2014 Project HOPE- The People-to-People Health Foundation, Inc.
PY - 2014
Y1 - 2014
N2 - Expenditures for specialty drugs account for more than 25 percent of total US drug spending and have been increasing at more than 13 percent annually.We examined insurers' role in maintaining the affordability and accessibility of specialty drugs while maximizing their value. We conducted two analyses: one using an administrative claims database with information on more than ten million commercially insured patients and another using the same database combined with the drug prescription records from a specialty pharmacy. First, we examined the prevalence of specialty drug coupons and the degree to which these reduced patients' out-of-pocket costs, focusing on 264,801 prescriptions. Second, we quantified the association between the magnitude of out-ofpocket costs for specialty drugs and patients' abandonment of their new or restarted therapy, focusing on a group of nearly 16,000 patients. We found that drug coupons accounted for $21.2 million of patients' $35.3 million annual out-of-pocket costs. In the vast majority of cases, coupons reduced monthly cost sharing to less than $250, a point at which patients were far less likely to abandon therapy with biologic antiinflammatory drugs or with drugs for multiple sclerosis. However, by reducing cost sharing, coupons may also circumvent efforts to encourage patients to use the most cost-effective drugs.
AB - Expenditures for specialty drugs account for more than 25 percent of total US drug spending and have been increasing at more than 13 percent annually.We examined insurers' role in maintaining the affordability and accessibility of specialty drugs while maximizing their value. We conducted two analyses: one using an administrative claims database with information on more than ten million commercially insured patients and another using the same database combined with the drug prescription records from a specialty pharmacy. First, we examined the prevalence of specialty drug coupons and the degree to which these reduced patients' out-of-pocket costs, focusing on 264,801 prescriptions. Second, we quantified the association between the magnitude of out-ofpocket costs for specialty drugs and patients' abandonment of their new or restarted therapy, focusing on a group of nearly 16,000 patients. We found that drug coupons accounted for $21.2 million of patients' $35.3 million annual out-of-pocket costs. In the vast majority of cases, coupons reduced monthly cost sharing to less than $250, a point at which patients were far less likely to abandon therapy with biologic antiinflammatory drugs or with drugs for multiple sclerosis. However, by reducing cost sharing, coupons may also circumvent efforts to encourage patients to use the most cost-effective drugs.
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U2 - 10.1377/hlthaff.2014.0497
DO - 10.1377/hlthaff.2014.0497
M3 - Article
C2 - 25288420
AN - SCOPUS:84907853401
SN - 0278-2715
VL - 33
SP - 1761
EP - 1769
JO - Health Affairs
JF - Health Affairs
IS - 10
ER -