The Ethics of Drug Coupons
“Coupons are ethical.”
According to an article in The Washington Post written along with Kaiser Family News, coupons for branded drugs have risen sharply from 86 drugs in 2009 to 395 in 2012. This explosion of coupons is done for a variety of reasons. For drugs going off patent they allow the branded manufacturer to compete with generics. For brands with patent life but with generic competition, it allows consumers to stay on branded drugs if they prefer that option. For brands with patent life and no generic option, coupons provide price support for those consumers who need some help affording the drug.
The use of coupons has been criticized by consumer advocates as leading consumers to expensive drugs that offer cheaper alternatives. While couponing may reduce consumer costs, the insurance company is paying more for branded drugs and hikes premiums to pay for them. Obviously, managed care and insurance companies dislike drug ads and promotional coupons. They want to have their formularies uninfluenced by consumer demand. DTC ads and coupons give their members a reason to complain if that advertised and couponed drug is not available on formulary.
I find nothing unethical about a drug company creating consumer pull. Managed care wants to dispense its favored drug and is usually the one that is cheapest. They prefer consumers and their doctor providers not be asking for newer alternatives. While their formulary choice may be fine in most cases, sometimes a newer drug is what is best for patients.
Coupons are used for everything in our free market, so why restrict them for drugs? Consumers get a price break and doctors can then prescribe a newer, and many times improved drug to their patients. I do not see consumers complaining about a $25 off coupon for a drug that has been prescribed. I do not think consumers are pressuring their doctor to write a drug just because they saw a coupon. The fact is these coupons are used mostly to make a drug the doctor prescribed more affordable. The patient wins when they can afford the best drug available.
Clearly, managed care and insurers would prefer coupons not be used. They say coupons lead consumers to choose branded drugs that have low cost alternatives. That may be true in some cases and physicians should prescribe the drug that is best for the patient regardless of list price. The insurance companies need to convince the doctor if this cheaper alternative is just as good. Consumer should have the option to lower their drug price any way they can; through coupons, mail order, and comparison shopping at pharmacies.
Coupons are ethical. DTC advertising is ethical. Getting consumers to buy your product is the free market system. The drug industry need not apologize for selling what they make, especially if it includes a tactic that lowers consumer price.
Bob Ehrlich, Chairman
DTC Perspectives, Inc.