Can UnitedHealthcare’s New Plan to Block Retail Copay Coupons Work?

By Lauren Flynn Kelly - April 4, 2014 In a recent pharmacy benefit update to its broker website, UnitedHealthcare unveiled a new tactic to block pharmaceutical manufacturer-offered copay coupons, which the insurer and many of its peers argue undermine payers’ formulary designs and raise drug costs. Unlike previously reported methods employed by health plans and PBMs to curb the use of coupons among commercially insured members, the insurer will work with its network retail pharmacies to discontinue their use as of July 1. The forthcoming “retail coupon initiative” is an ambitious move, and one that raises a lot of questions, such as how many pharmacies will actually participate and what will motivate them to do so. Will large chains, for instance, be willing to cooperate? And if one does, will it be expected to do the same for other payers that choose to take a similar approach? How will pharmaceutical manufacturers respond to the effort? When asked about some of the logistics of the program, UnitedHealthcare spokeswoman Lynne High responded with the following statement: “Our goal at UnitedHealthcare is to ensure consumers have access to affordable health care. That includes helping our members find the lowest-cost option for their prescription drugs. Use of manufacturer copayment coupons can drive patients away from lower cost, therapeutically equivalent alternatives and can significantly increase overall healthcare costs.” High pointed out that redemption of copay coupons is prohibited in federally sponsored health care programs, including Medicare and Medicaid, and that it is standard practice for mail-order pharmacies to not accept the coupons for 90-day maintenance medications. “We provide our members with several options including helping them find the therapeutically equivalent generic drug at a significantly lower cost; offering the convenience of a mail-service program; and covering $4 retail pharmacy copay programs,” she added. “Assistance from customer care representatives is available to members who can call the number on the back of their ID card or visit myuhc.com.” What challenges do you think UnitedHealthcare will face getting this initiative off the ground? And are others likely to follow suit? http://aishealth.com/blog/pharmacy-benefit-management/can-unitedhealthcares-new-plan-block-retail-copay-coupons-work?utm_source=Real%20Magnet&utm_medium=Email&utm_campaign=36937302