Copay discount programs stir up some strong feelings in the pharma world. They’ve been accused of driving up healthcare costs by increasing branded drug scripts when cheaper alternatives are available. Payers have thrown drugs off their formularies for that very reason. Drugmakers love them, because they help create brand loyalty and lower out-of-pocket hurdles for patients.
But a new trend could change that calculus: copay discounts for generic drugs and biosimilars.
Sun Pharmaceuticals is using copay assistance to promote its copy of Novartis’ big-selling, expensive cancer drug Gleevec. When the generic, imatinib mesylate, rolled out in February, Sun offered $700 in upfront out-of-pocket assistance, reducing the monthly copay to as little as $10.
After 6 months, more than 5,000 patients had used the program, which cut their out-of-pocket costs by 50% to 60%, Sun says. Those incentives were set to expire, but earlier this week, the Indian drugmaker extended the offer.
Meanwhile, Novartis’ Sandoz unit has its own copay program for patients using Zarxio, its biosimilar version of Amgen’s Neupogen (filgrastrim). The Sandoz One Source copay program covers upfront costs for patients, which means their first dose or cycle comes free of out-of-pocket expenses.
Patients then pay $10 for each monthly dose or cycle, for up to 12 months. The assistance program is limited to $10,000.
Contrary to copay help on branded drugs, these programs actually steer patients toward lower-cost therapies. The price difference between biologics and their biosimilars is much smaller, of course, than the gap between brands and traditional generics. But even so, payers have been anticipating savings on biosimilars for some time, and they’re likely to welcome this new variety of copay program.
The 2017 formulary released by CVS Health last week shows just how much the pharmacy benefits manager hopes to rely on Sun’s Gleevec copy and biosimilar meds. CVS removed not only Gleevec but also Novartis’ follow-up med, Tasigna, from its preferred formulary.
CVS also removed Amgen’s Neupogen from its list in favor of Zarxio, and it excluded Sanofi’s Lantus, preferring to cover Eli Lilly and Boehringer Ingelheim’s biosimilar, Basaglar, instead. The latter med is expected to launch in December.
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