When Doctors’ Orders Are Not Followed: Are Co-Pay Cards Kick-Backs or Just Good Marketing?

Co-pay cards provide patients a discount off all or part of the co-pay that they would otherwise have to pay. Saving money — it sounds like a good idea for patients, right?

Community Catalyst, an “organization working to build the consumer and community leadership that is required to transform the American health system”, disagrees. Community Catalyst recently filed class action lawsuits claiming:

while prescription drug coupons appear to save consumers money by reducing or eliminating co-payments, in reality they dramatically increase the cost of health care by driving up health insurance premiums and potentially causing consumers to hit benefit caps or lose coverage altogether.

Health insurance companies agree with Community Catalyst. Reports the NY Times,

Executives of a small insurance company in Albany were mystified when, almost overnight, its payments for a certain class of antibiotics nearly doubled, threatening to add about a half-million dollars annually in costs …

Eileen Wood, a vice president at the Albany insurance company, Capital District Physicians’ Health Plan, found her own solution. Her company started requiring patients to try the generic before using Solodyn. The cost per claim dropped back down.

What this all means is that doctors prescriptions are not being followed. Because what is being said is this – A co-pay card that is used after and only after a patient’s doctor prescribed a drug that the doctor, in his or her medial opinion, is needed for the patient is not a good thing; but, forcing these patients to use a different drug that the doctor did not prescribe is a good thing.

Only the prescribing physician has personal knowledge of the medical needs of the patient — not the drug company that is making and selling the drug, nor the advocacy group, nor the health insurance company.

Where is the voice of the prescribing physician? So, are co-pay cards kick-backs or just good marketing?

What do you think?

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