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A web-based survey to assess perceptions of managed care organization representatives regarding the use of co-pay subsidy coupons for prescription drugs
textPharmaceutical manufacturersâ use of prescription brand-name drugs coupons and vouchers to subsidize patientsâ cost-sharing obligations such as co-pays has increased. The co-pays are used by managed care organizations (MCOs) to give their plan members an appreciation of drug costs as well as to offer incentives to use available equivalent generic alternatives due to lower co-pays. With higher tiered co-pays for brand-name drugs being offset by coupons, little is known about MCO representativesâ perceptions about use of co-pay subsidy coupons for brand-name prescription drugs.
The objective of this study was to assess health plan managers and pharmacy benefit managers (PBMs) perceptions on the use of prescription drug co-pay subsidy coupons. An online survey instrument was used to collect data. A convenience sample of 834 MCO representatives was selected from the Academy of Managed Care Pharmacy (AMCP) membership directory. A total of 122 surveys were returned of which 105 were usable surveys, giving a response rate of 13.7%. A five-point, 11-item Likert scale ranging from 1 through 5, (1 = âStrong Disagreeâ and 5 = âStrongly Agreeâ) was used to measure respondentsâperceptions. Some items referred to coupons used to get co-pay discounts repeatedly over a year (i.e., long-term
use coupons) while some items referred to coupons distributed for trial purposes (i.e., short-term use coupons). Of the 105 respondents, 42 (40%) âagreed,â while 58 (55.2%) âstrongly agreedâ that co-pay subsidy coupons encouraged non-preferred brand-name drugs over preferred brand-name
drugs. A total of 78 respondents (74.3%) reported that brand-name drug coupons undermined tiered formulary structure. Sixty respondents (57.1%) âstrongly agreedâ that short-term use coupons increased plan sponsorâs costs and 72 respondents (68.6%) âagreedâ that sponsor cost increased with long-term use coupons. A total of 42 (40%) reported to âstrongly agreeâ that short-term use coupons should be eliminated whereas 49 (46.7%) respondents reported âstrongly agreedâ that long-term use coupons should be eliminated.
In summary, MCO representatives believe that brand-name drug utilization is increasing due to prescription drug incentives such as coupons which undermines their formulary controls and in turn, increases health care costs.Pharmac