Drug Companies Turn to “Smart Cards”

At a time when the cost of healthcare has become a key issue in the US economy, every effort to mitigate the problem should be welcomed. The nation's major pharmaceutical firms have traditionally offered a variety of patient assistant programs (see http://www.rxassist.org/) to reduce drugs costs. Pharmaceutical companies have long distributed drug samples, but sampling is slowly being curtailed by growing restrictions against visits by sales representatives. An alternative way to obtain discounted medications for patients is through vouchers -- typically in the form of coupons or cards -- to patients for discounted prices on medications. Many of the vouchers cover the entire copayment, thus eliminating any out-of-pocket cost for the patient. These voucher programs may encourage patient compliance and persistence in following the physician's prescription and treatment plan, and there is no cost to the physician or the patient. The physician's role --- and it is a key one --- is to provide one of these vouchers to each patient at the same time that a prescription is written for that product, before the patient leaves the office. Coupons have been around for many years; the debit-type card is a newer voucher approach, which has a number of advantages over the coupon. As with coupons, each card program begins when a pharmaceutical company wants to promote a particular drug product still on patent. Various factors play into the creation of a card for a specific drug, including the value to the patient of each card, the number of times that it can be used by the patient (which can range from 1 to 12 times for prescription refills), and the number of cards produced, which depends on an estimate of the market for that drug. The cards, like coupons, are then distributed directly to physicians by mail, by the pharmaceutical company's representatives, or they can be printed out online.

The technology backing the card enables it to be used either when the prescription is filled at an in-store pharmacy or online. The patient hands the card with the prescription to the pharmacist. At that point, the card has no value attached to it. As soon as the pharmacist adjudicates the prescription, the card, which is linked to a bank, is instantly and automatically loaded with a value that typically covers the patient's copay amount, so that the patient has no out-of-pocket cost. This transaction also benefits the pharmacist, since unlike the traditional voucher or coupon, which requires a delay in reimbursement, the value on the card is automatically and immediately transferred to the pharmacy. The technology developed for these card programs can also allow payment for prescriptions filled online.

The details of all programs are available from the pharmaceutical companies or from their representatives. Many firms also list their current offers on their official websites. A number of consumer websites now list the available products for which coupons are available. (Examples include: www.InternetDrugCoupons.com and www.ReducePrescriptionCosts.com.) These sites, designed only for consumers, generally refer site visitors to available paper coupons only, and do not necessarily involve the physician.

-Adapted from: “Saving Your Patient Money With Smart Cards? Priceless!”, by Nils A. Shapiro, BBA , Medscape Family Medicine.  2008; Posted 11/03/2008, Sent to CRC by Anthony Provazza (thanks Anthony!), retrieved 11/12/08 from: http://www.medscape.com/viewarticle/582566.

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