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When getting medications, Independence members may occasionally use a
prescription drug voucher card to lower out-of-pocket expenses. However, these
cards may not actually contribute toward long-term savings. It is important to
understand what these cards are and when they can help members save money.
What is a prescription drug voucher?
A prescription drug voucher is typically offered by pharmaceutical companies
that manufacture brandname or specialty medications. These vouchers can be
taken to a pharmacy and used to lower or eliminate a member's insurance
copayment or out-of-pocket cost for a prescription medication. The
pharmaceutical company covers the cost of reducing the copayment. Many of these
vouchers are available on the Internet or at the physician's office. They prove
to be especially beneficial for members in scenarios where all other
prescription drug alternatives are also high cost brand-name or specialty
products.
Potential issues with use
Generally, generic medications have the lowest copayment and brand-name
medications have the highest copayment. Independence uses cost-sharing to
direct patients to more cost-effective medications, such as when generic
alternatives are available. We design formulary tiers and copayment
cost-sharing to encourage price competition and reduce drug costs. These tiers
are designed as an incentive for members to choose clinically appropriate
medications with the lowest net cost.
Prescription drug vouchers may discourage members from choosing the least
costly, most clinically appropriate medications. When pharmaceutical companies
offer prescription drug vouchers, they reduce or eliminate the higher
copayments associated with their brand-name or specialty medications. This
narrows the copayment differential between the generics and brands and may
encourage the patient to go with the brand-name medication. Despite the lower
copayment, the gross cost of the drug remains unchanged because the insurance
company's cost still applies.
As brand-name medication utilization increases, the insurance company's
overall costs also increase. This may ultimately affect the premium insurance
companies charge to offset expenses. According to the Pharmaceutical Care
Management Association, the use of prescription drug vouchers will increase the
prescription drug spending for commercially insured patients by $32 billion
over the next ten years. This will inevitably increase health insurance
premiums for all parties. It is important to understand that even though a
patient's prescription may cost less that month, it may ultimately raise
overall health care costs.
How you can help
It is important to understand how prescription drug vouchers work before
accepting them from pharmaceutical companies and distributing to patients. It
is also important to remind patients of the potential downstream effects of
these vouchers when seeking savings opportunities for their prescription
drugs.
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