To understand the contribution of drug discount cards to the demise of independent pharmacies, one has to realize that those “discounts” can be ‘clawed back’ in DIR fees, so that the pharmacy owner (and ultimately the patient) foots the bill. How does the pharmacy owner break even when the total reimbursement is barely above or less than the purchase price of their drugs?

In the end, the blame goes back to exorbitant drug costs and the casualties are all of us. Consider the medicare eligible population who can not or will not take their medications as prescribed, citing high co-pays. In this population, stretching insulins, asthma/COPD inhalers, glaucoma eye drops and other important medications is a common practice and many end up being repeatedly hospitalized for their “poorly managed” yet treatable conditions. As we lament their “poor adherence”, insurance providers point to those unbelievably expensive and frequent hospitalizations to justify expensive plan premiums.

Until we have comprehensive legislative measures to address the multi-factorial contributors to exorbitant medication costs and in the absence of cost-effective formulary alternatives, I usually share manufacturer co-pay assistance programs as a resource. When available, these programs may be the only options for medicare clients in an unenviable income range - those who make too much to qualify for state assistance (e.g. Connecticut Medicaid or Connecticut Medicare Savings Programs ) but earn too little to manage growing health costs. There is a chance they may qualify for manufacturer programs that have more accommodating income eligibility requirements e.g. within 300% - 400% of the Federal Poverty Level.

While these programs may be a ‘band-aid on a bullet hole’, or worse, an entry point into a feedback loop that fails to address the roots of our national healthcare expenditure problem, they remain an accessible way for this pharmacist to fulfill her goal to help people afford their medications.