Copay Offset Cards: Attitudes & Experiences of Stakeholders & Implications for Continuation

Copay offset cards have a grown a great deal in popularity and usage over the past few years. Pharmaceutical companies are offering these cards to reduce, or eliminate, the copay amount required to be paid by patients. The number of companies offering these cards has increased over the years, but despite wide spread use, very little information is available regarding the attitudes and experiences of important stakeholders such as patients, pharmacists, physicians and payers.

In the near term, sponsors of these cards will be making important decisions regarding their continuation and enhancements being made to them. It will be vital to weigh the opinions of the various stakeholders before coming to a decision on whether to enhance or discontinue these programs.

Currently there are approximately 400 active products in the market that have copay offset cards available to patients. The cards reduce the amount of out-of-pocket copay due from patients for a specific prescription, so each product must have its own card. The cards are wide-spread within top pharmaceutical manufacturers, with companies such as Abbott, AstraZeneca, BristolMyersSquibb, Merck, Novartis and Pfizer all offering them for some of their products.

There are differing opinions on the offset cards depending on which stakeholder in the equation you speak to. Many feel that by increasing the affordability for patients to purchase these products, copay relief cards increase adherence and persistency among those patients. However, some are not in favor of the programs as they feel they promote the use of expensive brand name drugs where a cheaper generic alternative is available.

With some preliminary data now available, it appears the majority of physicians are in favor of the copay offset programs. The affordability for patients allows them to have less boundaries for treatment, as they are not as limited on product choice due to price differences. The minority voiced concern that they encourage the use of the higher priced drugs over generics, which could ultimately increase the cost of healthcare in the long run.

There has been some speculation on whether the majority of copay offset cards were being issued for products that had no competition, or ones with brand and/or generic counterparts. Some preliminary data confirms that most copay offset cards are offered on products that do have generic and/or brand competition. In these cases, the brand name product with the offset program ends up costing less than the competition, whether brand or generic. This is where some stakeholders such as the payers start to have concerns on the future of healthcare.

The obvious winner in this equation is the patients. With the rising cost of healthcare, they receive some relief at the pharmacy with these programs, and that’s the main reason they were instituted. The questions remains if through benefiting the patients in the short term, the overall healthcare industry with have long term negative effects as a result in the various pieces of the puzzle.