Evaluation of Heart Failure Medication Prescriptions using an Online Drug Discount Program

Abstract

Introduction Drug discount card programs have emerged as an additional option for patients to offset the increasing costs of drugs. However, there is limited knowledge about online drug discount programs and their role on prescription medications. We evaluated the frequency of drug discount card utilization and estimated cost savings associated with heart failure (HF) medication prescriptions. Methods We conducted a retrospective study of all HF prescriptions filled through the NeedyMeds.org drug discount card program nationwide, from January 2009 to December 2016. We evaluated the frequency of drug discount card prescriptions (across pharmacy types, pharmacy location, by prescriber specialty and by drug class) and calculated cost savings (average per drug discount card and total program dollars saved) for entire study period and for each year (from 2009 to 2016). Results We identified 381,347 prescriptions (8.2% of all prescriptions) for medications that can be used for heart failure with drug discount cards (83.7% at national, 5.7% at regional and 9.8% at local pharmacies). Most prescriptions were filled at urban locations (89.1% in urban clusters, 7.6% in urbanized areas) and in ZIP-codes with lower median household income (65.5%). Angiotensin-converting enzyme inhibitors and selected angiotensin receptor blockers were the most prescribed drugs with discount cards (44.3%) followed by beta blockers (27.1%), diuretics (21.8%), and mineralocorticoid receptor agonists (3.5%). The prescriptions for newer drugs were limited (sacubitril-valsartan: 12; ivabradine: 27). The number of HF prescriptions with discount cards increased from 2577 in 2009 to 64,750 in 2016. Similar increases in the number of prescriptions were noted across all drug classes. A total of 224,049 prescriptions for HF medications (59% of the total) benefited from the program resulting in total savings of $4,739,204 with a median cost saving of $9.30 (41.5%) per prescription. Conclusion Drug discount prescription use increased during the study period, resulting in cost savings on HF prescription medications (approximately $9 in savings per prescription) compared to the original cost charged by pharmacies. Lack of use for newer drugs may suggest unwillingness of pharmaceutical company or pharmacy benefit manager to provide this option. Overall, while on-line drug assistance programs may reduce financial burden for generic drugs, pricing transparency remains obtuse.