There is no question that Kevin Pho is a smart guy. In addition to being a practicing, board- certified internist, he is also one of the most visible physicians on the Internet. In fact, he bills himself on his KevinMD.com web site as ‘social media’s leading physician voice.’ and he is. He contributes pieces about medicine and health regularly to various established media.
But in a recent column about prescription drug coupons for USA Today, where he is a member of the board of contributors, Pho appeared to faulty logic. The premise he discussed was that prescription coupons are no bargain and offered familiar arguments about the long-term hidden costs that insurers maintain are associated with these promotions.
Over the next decade, he cites estimates that coupons will add to prescription drug spending by $32 billion. (This $32 Billion figure was originally calculated by the Pharmaceutical Care Management Association, which is trade association and advocacy group for pharmacy benefit managers such as and prescription benefits managers such as Aetna, Cigna, CVS Caremark, etc).
PCMA is biased against drug coupons because drug coupons cut into their profits. (Think flies being against fly swatters). After their report was published, the $32 Billion drug coupon cost inflation was repeated 100’s of times on the internet and in the media and now people mistakenly take it for gospel fact.
“Over time,” Dr. Pho writes, “those costs will come back to haunt patients.” How so? He quotes a spokeswoman for the health insurance industry as saying that the discounts obtained today may disappear tomorrow due to limits on usage or abrupt expirations.
“When this happens, patients whose chronic diseases are managed by expensive brand-name drugs are left to financially fend for themselves. Without the coupon or a generic alternative, the patient’s co-pay rises,” he writes. “And if a generic is available, many patients fail to change to the cheaper alternative with their doctors. As a result, their annual drug costs can easily rise by several hundred dollars.”
But wait. The same patient who was hungry enough to use a coupon in hopes of saving money would later not be smart enough to consider finding lower-cost alternatives if a coupon was no longer available? Are that many patients so uninformed? Increasingly, consumers are seeking drug coupons after learning of their availability, so why wouldn’t these same people stumble across generics?
“Patients should talk with their doctors and do the math. Most conditions can be treated with generics,” he adds, before cautioning that, “even with coupons, co-pays for brand-name drugs can exceed generics.” Maybe this is true for certain situations, but these need to be handled on a case-by- case basis, of course. For instance lots of brand name drugs have no generics
Pho is correct to urge patients to do the math. Instead of cautioning patients about coupons, though, they should be encouraged to consider such options. After all, consumers are fully capable of recognizing higher costs and seeking ways to reduce them.