Based on his firm’s analysis of various data sources, Mason provides a spirited defense of co-pay offset programs. He argues that co-pay cards don't increase utilization of higher-cost brand-name drugs and don't reduce generic usage, but do increase adherence.
While the article lacks sufficient details to fully evaluate its empirical claims, it still makes a useful contribution by explaining how and why co-pay offset programs can be a valuable benefit management tool.
What do you think: good or evil?
The article is a response to last November’s highly negative Pharmaceutical Care Management Association report, which claimed: “Copay coupons induce consumers to choose higher-cost brands (despite higher copays) over lower-cost competitors (despite lower copays).” See PBMs Launch a New Attack on Copay Cards.
In contrast, Mason states that “there are actually far more copay card program transactions that are used by Tier 2 contracted prescriptions than by Tier 3 non-contracted prescriptions.” (See A Look at Drug Benefit Tiers in 2011 for an overview of benefit tiers.) Here’s his logic:
“The largest brands in the class have an advantage in negotiating for Tier 2 access, as they have the most drug spend 'in play.' The third or fourth brand to launch in the class ends up 'non-preferred,' and, in order to get high-quality access for its drug, initiates a copay card program. The larger brands, despite having contracted to get patients lower copayments, are afraid to lose their advantage and 'double down' by instituting a copay card offset program.”He also points to the lack of correlation between generic utilization and co-pay offset (per the chart below).
The last chart in the article summarizes a case study that shows increased patient adherence with co-pay offset. These data are consistent with peer-reviewed studies on the relationship between co-payment levels and abandonment. See Co-Payments and Prescription Abandonment.
So, Drug Channels readers, what do you think about Mason's point of view?