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June 8, 2010

Drug coupons not a good deal after all

To the editor:

Though I seldom agree with him, I usually read Taylor Armerding's column in The Daily News. At the same time, I'm learning about some issues from my adult son, who happens to work in a nonprofit agency, Health Care for All, which takes positions on just the topic Mr. Armerding discussed recently. In "Government never tires of protecting us from ourselves" (May 29), Mr. Armerding's reasoning seems pretty simple: Government rules are bad; coupons for consumers of prescription drugs are good. To Mr. Armerding, the members of the Massachusetts House of Representatives did us all a favor by allowing big drug companies to provide us with coupons for name-brand drugs.

Here's what I learned from my son: The coupon issue is more complicated than Mr. Armerding makes it appear. For example, let's say "Joe" needs a maintenance drug (one that he takes indefinitely) and is comparing prices. He looks at the price for the generic form and learns that his co-pay under his insurance plan is, perhaps, $25 per month. The insurance company, for its part, may pay an additional $75 per month to provide this drug to Joe.

Then Joe takes a look at the cost of the name-brand version of the same drug: His co-pay is — to his distress — $50 per month. The insurance company will also have to pay more, perhaps $150 per month.

But wait! Joe's pharmaceutical company is offering him a coupon — for $25 — so that he can purchase the name-brand drug after all, for the same $25 out-of-pocket cost, in the end, as the generic. Sounds like a good deal to Joe.

Here's the point, though. If Joe uses the coupon and opts for the name-brand drug, Joe's insurance company still has to pay its share: $150 rather than $75 for the generic. And here are the questions that arise from this scenario: If a pharmaceutical company can afford to sell a drug for less (as it did for Joe, with his coupon), why doesn't it sell it for less to everyone, without coupons? Are other patients subsidizing the cost of Joe's coupon? Most important, what effect do coupons from drug companies that "help" people to buy name brands have on everyone's insurance premiums, and on the cost of health care?

Susan J. Noyes

West Newbury

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