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Copay Coupons Improve CV Drug Adherence But Not By Much

Health Outcomes Have No Improvement

Critics of copay coupons blame them for driving up drug costs. A study in JAMA shows that using coupons had a slightly positive impact on medication adherence, but they didn't improve health outcomes in patients who’d had a heart attack. They also encouraged doctors to prescribe costlier, more effective options.

A study of P2Y12 inhibitors divided 301 hospitals into groups of doctors who offered copay coupons to their patients and doctors who did not. After reviewing more than 11,000 heart attack patients, investigators found that those who received coupons had a 3.3% increase in medication adherence after one year compared to those who received no coupons, but they had no benefit in health outcomes.

Also, the coupons appeared to make doctors more comfortable prescribing guideline-preferred, more expensive treatments. Doctors in the coupon group were more likely to prescribe ticagrelor (Brilinta, AstraZeneca) and prasugrel (Effient, Eli Lilly) over clopidogrel (Plavix, Bristol-Myers Squibb).

Moreover, only 72% of patients who received a copay coupon actually used it. And the patients who did not use their coupons were more likely to have a lower income or to not have insurance.

Manufacturers say coupons help patients afford their drugs, but payers and critics maintain they force costs up by encouraging the use of costlier options. Some payers believe the coupons encourage waste in the health care system and offer limited savings for patients that ultimately lead to higher premiums or fewer benefits.

Source:, January 17, 2019

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