State’s ban on drug discounts is a bitter pill
Boston Herald
June 13, 2009
By Lawrence M. DuBuske
Health care reform has been a wonderful blessing for the many residents of this state who were previously uninsured. But for many of these newly insured patients, the large co-pays for vital medications which they face from their insurance companies create a major barrier to care.
The situation has been exacerbated by the current economic crisis and medicine’s increasing reliance on miraculous but extremely expensive biologics. Just the co-pays for these therapies can run into the thousands of dollars per year.
As a consequence, many patients with otherwise adequate insurance are being forced to make decisions about whether to fill prescriptions with high co-pays or go without their medications. On a recent day in my own office, I saw four patients who had elected not to fill their prescriptions from their last visit with me because of high co-pays for medications vital to treating their asthma. This is a frightening situation that could lead to fatalities from this disease.
There is a solution, one that would not cost cash-strapped state government a dime: Allow pharmaceutical companies to provide coupons and other discount programs to Massachusetts residents with private medical insurance.
Massachusetts is the only state in the country that bans such discounts. One unfortunate irony of the ban is that some of the expensive biologics to which many Bay Staters do not have access are being developed right here in Massachusetts, a major center of biotechnology.
Another consequence is that patients along the borders are crossing into other states to buy drugs, costing Massachusetts pharmacists business.
Insurance industry claims that drug discounts are a ploy to hook patients on brand-name drugs, as opposed to less expensive generics, are unnecessarily suspicious. First, pharmaceutical companies do not offer discounts for or otherwise invest in brand-name drugs for which a generic exists. At that point, the drug has ceased to become profitable. Two, if an insurance company wanted to disallow discounts nonetheless, it could still do so for members of its own plan.
Legislation lifting the ban, filed by Rep. Peter Koutoujian (D-Waltham), would simply remove the government’s prohibition on discounts.
Massachusetts has spent enormous energy and resources on providing universal health insurance coverage. Why would we now maintain an economic barrier to life-saving drugs, especially when removing that barrier would cost taxpayers nothing? Discount coupons could mean the difference between a patient getting a medication vital for their asthma or going without medication and risking a fatal asthma attack. » link