Options when your drug copays are too expensive

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From a KevinMD.com article by LESLIE RAMIREZ, MD

You have insurance and, supposedly, it covers your medicines. However, you still get stuck with a portion of the bill that the insurance company calls a “copay.” In some cases these copays can run more than $150/ month per medication (e.g. Enbrel). If you are on more than one of these expensive, branded medications the copays can really add up. What are your options?

 1. Generic alternative. Always ask your doc if there is a reasonable generic alternative. This is always the best option for you in the long run. However, if there truly is no generic medication that comes close, then check into either (or both) of the next two options.

2. Drug specific copay programs. These programs are run by the manufacturers of the drugs, aka Big Pharma (BP). Usually, these discounts are given to all patients, regardless of income.  But make no mistake, it is a way for BP to circumvent your insurance company’s cost control mechanism for prescriptions. By picking up part or all of the cost of your copay, BP trying to make their product more attractive to you and to your physician. But when the manufacturer stops offering the copay discount programs you will be back to square one. However, if according to your doctor, you must be on one of these drugs, then by all means, take advantage of the savings while they last. In the case of Enbrel, the Enbrel Support Card Program picked up the tab for six months worth of copays. To find out more info on whether such a program exists for your medication, there are many websites out there, including the manufacturer’s site.

However, I found the following two websites particularly useful:

Internetdrugscoupons.com This website shows you all available drugs that have coupons, copay and otherwise,  associated with them. It’s an ugly little site, and ignore the annoying ads for a prescription savings card. But it couldn’t be simpler to use. And all the coupons I clicked on were still valid- so it seems like the folks behind it keep it up to date. According to the mission statement on the website “[The founder] assembled this database of drug coupons to make it easy for people like my elderly parents to save money on their medications.”

RxAssist.org This is a super slick website that allows you to look up your medicines, albeit individually, to see what deals are offered. When you see a deal you click on the medicine and you are directed to the manufacturer’s website. According to the About section of the website, RxAssist.org was established in 1999 with funding from The Robert Wood Johnson Foundation.

3.  Disease specific copay programs. There are many organizations that offer patients with specific diseases, such as cancer and HIV/AIDS,  assistance with their prescription copays. These programs often require financial ability-to-pay information from you to qualify for assistance. Disease Specific Copay Programs is a very comprehensive list of copay and other assistance programs compiled by a BP-funded site called Partnership for Prescription Assistance, aka PPArx.org.

Leslie Ramirez is an internal medicine physician and founder of Leslie’s List, which provides information that enables all patients, but especially the uninsured and underinsured, to find more affordable medications and health care services.

Related articles

• Copay Cards: Don’t Throw The Baby Out With The Bathwater (georgevanantwerp.com)
• Short Survey On Copay Cards (georgevanantwerp.com)
• Institute of Medicine Recommendations Released; Birth Control Could Become a Copay-Free Preventive Service (womenshealthnews.wordpress.com)
• Prescription Med Prices Set to Plummet (abcnews.go.com)

How do data exclusivity periods affect pharmaceutical innovation?

How do data exclusivity periods affect pharmaceutical innovation?

Study is first to estimate financial and social impact of extending exclusive access to clinical trial data for conventional drugs

From a January 6, 2011 Eureka news alert

LOS ANGELES, Calif. — January 6, 2011 — Pharmaceutical companies and generic drug manufacturers have long been at odds over regulations about “data exclusivity,” the period of time before generic manufacturers can make use of valuable clinical trial data.

A new study in the January 2011 issue of Health Affairs *** is the first to calculate the financial and social costs of limiting access to trial data — and finds that extending the term of exclusive access will lead to higher drug costs in the short term but also to more than 200 extra drug approvals and to greater life expectancy in the next several decades.

“Elected officials are unlikely to embrace legislation that would result in higher drug prices, but our research suggests that legislation to extend data exclusivity would spur innovation that would benefit future generations,” explained Dana Goldman, lead author, director of the Schaeffer Center for Health Policy and Economics at USC and Norman Topping Chair in Medicine and Public Policy at USC.

The pharmaceutical companies that introduce new drugs are currently granted five years of exclusive access to the clinical trial data they submit during the approval process. An extension of three years is available if new applications arise and a six month extension is granted if the drug is approved for use in pediatric populations.

In 2007, the National Academies Committee on Science, Engineering and Public Policy called for extending this “data exclusivity” term to the longer period used in Europe, ten to 11 years. But generic manufacturers have argued for shorter limits so that they can bring less expensive versions of drugs to patients sooner.

“Unfortunately, the health policy literature contains no information about the effects such a policy would have on innovation, population longevity and social welfare,” said Darius Lakdawalla, research director at the Schaeffer Center at USC and associate professor in the USC School of Policy, Planning and Development.

In the first study to directly address these issues, the researchers estimate that extending the term of data exclusivity to 12 years would increase the lifetime revenue of a drug by 5 percent, on average.

With empirical evidence that profits drive drug innovation, this longer term would lead to an additional 228 drug approvals over the next fifty years and an increase of 1.7 months in average life expectancy, according to the study.

John Romley, an economist with the Schaeffer Center at USC and research assistant professor at the USC School of Policy, Planning and Development, acknowledged the trade-off between current and future generations: “Americans in the early 2020’s would bear the cost of increasing drug spending. However, people turning 55 in 2060 could expect increased life expectancy as a result of innovation in the interceding years — that is, new drugs brought to market because of lengthier data exclusivity.”

***Click here for suggestions on how to get this article for free or at low cost

Generic Drug Roundup: December 2010

From the US Food and Drug Administration Web Page

Each year, the Food and Drug Administration (FDA) approves many generic drugs that treat a wide variety of conditions and help consumers save money.

Significant FDA approvals of generic medications are listed below.

Be aware that the notes included with the description of each drug listed below do not include all warnings, side effects, or use instructions associated with these products. You should read the medication guide, when available, and speak with a health care professional regarding any medication you are taking, have been prescribed, or are considering taking

• Anastrozole Tablets
• Venlafaxine Hydrochloride extended-release capsules
• Aztreonam (for Injection)
• Enoxaparin Sodium Injection
• Losartan Potassium Tablets
• Generic Drugs: Vital Facts
  • Generic drugs are identical to their brand-name equivalents in dosage, safety, strength, quality, performance characteristics, intended use, and the way they’re administered to patients.
  • On average, the cost of a generic drug is 80 to 85 percent lower than the brand-name product.
  • New drugs are patented to protect the investments of the manufacturers that develop them. As patents or other periods of exclusivity on new drugs expire, manufacturers—including firms that did not develop the drugs—can seek FDA approval to sell generic versions.

This article appears on FDA’s Consumer Updates page, which features the latest on all FDA-
regulated products.

For More Information

• Facts and Myths about Generic Drugs
• Understanding Generic Drugs
• Drug Approval Reports by Month