Drug Manufacturers Now Offering Purchase Protection

LITTLE ROCK, Ark.-  From Capitol Hill to the Corner pharmacy  the cost of prescription drugs is one of the hottest topics across the country.

According to latest numbers, consumers spend over $300 billion dollars a year on prescriptions.

Shoppers are used to money back guarantees for everything from razors to toilet paper. However,  consumer products aren't the only things now offering purchase protection.

"Money back guarantees for drugs is a relatively new phenomenon," said Dr. Mark Fendrick, Director of University of Michigan center for value based insurance design.    

Some prescription drugs now promise to perform or the manufacturer or pharmacy benefit company will provide a discount or refund.

Before you get too excited, though, Dr. Fendrick says, in most cases, the refunds don't go directly to patients.

"In the early situations, most of the time the money goes back to the health plan or the employer."

One example being Cigna, who says it has entered into "value-based contracts" for medications designed to treat conditions such as heart failure and multiple sclerosis.

There are agreed upon health metrics to measure whether a drug meets expectations. under some contracts, if a drug doesn't perform as expected, the manufacturer will reduce the cost to Cigna's benefit plans.

The company says these deals "align financial terms to measured improvements in customers' health".

David Mitchell, of "patients for affordable drugs", says the guarantees are little comfort to sick patients.

"Money-back guarantees don't work because it allows the manufacturer to keep control of the price of the drug, and (2) no drug should be given to people if they are not effective to begin with and the fda determines that," Mitchell said. 

Dr. Fendrick says, in some cases, guarantees won't directly impact patient costs, but they are supposed to help insurers keep premiums from going up.

"It's increasing accountability and transparency for drugs and drug effectiveness," said Dr. Fendrick.  

Novartis, which makes some drugs that offer rebates and guarantees, says that "by collaborating with payers on outcome based contracting solutions, we hope to help drive a shift toward value pricing in the healthcare system."

Express Scripts offers its own guarantees and tells us its hepatitis-c program has "lowered the cost of the treatment for payers by nearly 50%" since 2015.  express scripts has also granted 50K patients access to care that may be rationed by some providers.

Mitchell,  who is a cancer patient himself, feels there's a better way.

"Let's just lower the price at the outset."

Novartis tells us uninsured patients may be eligible to receive low or no cost drugs through their patient assistance program. 

Similar programs exist with other leading manufacturers.


 


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