I agree with writer Kristine Binette (Maine Voices, April 12) that drug prices are out of control. But Big Pharma, and it alone, sets and raises prices year after year and games the system with bait-and-switch tactics.‘

Here’s how: Big Pharma offers a “copay coupon” to a small percentage of patients, for a short time period, to incentivize them to use expensive drugs. Once a patient hits their maximum out-of-pocket expense, drugmakers stop providing coupons – leaving insurance to pick up the tab, which raises premiums for everyone.

Health insurance providers never see the value of a copay coupon. Big Pharma hands out a coupon with its left hand and pockets those dollars with its right – all in the interest of keeping their prices high. With copay coupons, Big Pharma is essentially paying itself.

Ultimately, the solution is to lower the cost of drugs, eradicating the need for coupons. But as long as monopoly powers prop up astronomically priced drugs, insurers recognize coupons as a bridge for consumers to gain access to these specialty medications. What shouldn’t occur is the double-dipping of both the application of coupons to pay for the drug and for that third-party payment to be credited to a consumer’s deductible.

Big Pharma should simply lower the prices of their drugs for everyone. Until then, patients, employers and policymakers should recognize that coupons should not be allowed to be credited toward deductible and maximum out-of-pocket spending thresholds. Doing so only increases the costs for everyone else.

Katherine Pelletreau
executive director, Maine Association of Health Plans
Cumberland Center

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