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Rising Copays

Posted 10/18/2016

Posted in

  Any of us who pay co-pays for medications or medical visits is aware that our costs are rising. We are nearing the annual insurance enrollment for most Americans (usually is November), and it is a safe bet that our costs will be even higher in 2017. As an example, I receive monthly injections for ongoing breast cancer treatment; the co-pay has risen over the past few months (and, no I don't understand why) from $9.55 to $207. This is nuts!

  Clearly, as drug prices are rising, insurance companies are trying to shift more of the cost to consumers. In theory, this may make some sense as it motivates patients to be more aware of their choices and to perhaps consider medication changes (assuming there are less expensive drugs that are equally effective. In many cases there are; the cheaper drugs are just older.) The opposing argument is that this policy just avoids the real problem which is the cost of the drugs.

  This is an excellent summary from Eureka Alert about this issue:

Copay assistance is the problem, not the
solution to high drug prices


Copay assistance is the problem, not the solution to high drug prices, policy experts say

Copay assistance is part of the drug pricing problem, not a solution to it, according to several health policy
experts in a commentary published in Annals of Internal Medicine. The experts offer five reasons why programs like the one offered by Mylan, the pharmaceutical company responsible for the controversial Epi-Pen price hike, look like a boon for public health but are actually a recipe for higher healthcare costs.
As drug companies raise medication prices, insurance companies reduce coverage, and consumers are left
paying higher out-of-pocket costs. Pharmaceutical companies could ease consumer burden by lowering prices, but they often opt for Mylan's strategy instead. That is, they offer coupons to offset patient costs or form charities to administer support programs for patients with government insurance. The authors outline several reasons why these copay assistance programs will lead to more expensive drugs in the future and also offer suggestions for health care policy makers to mitigate their inflationary impact.


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