There is good news for the pharmaceutical company image. For the second year in a row, the Harris Interactive ranking of companies shows a definite improvement for the industry. The measure has historically been volatile.
However, also this week, concerns were raised about the practice of couponing as a marketing strategy when 24 patient advocacy groups asked the FDA to ban couponing.
The fear is that coupons, among other things, influence the prescription the physician is writing for the patient. A primary principle for patient advocates is that nothing should come between the patient and physician in deciding care – not a managed care practice and not a pharmaceutical marketing practice.
I understand that point of view entirely. I think couponing is a practice that could widely be perceived to influence a patient’s desire for a drug based on price, rather than based on the fact that the prescription is the right thing for the right patient. But it is not as if we are talking about a coupon for chemotherapy here, or even for an anti-depressant. A coupon for one sleep aid over another may not be such a big deal. Why shouldn’t a patient get a break on price?
But if patient advocates are going to stand on the principle that couponing does interfere with patient access decisions, by the same token, they need to address the other end of the spectrum – restrictive formularies that limit the choice of a poor patient – something that couponing might actually help. If a patient has a formulary that is restricting access, leaving the patient to decide between using a substitute drug or paying for the drug outright, a coupon could help the patient get access to the drug he or she wants.
That said, with the increasing negative focus on direct-to-consumer, perhaps couponing should be studied further before it is banned, to weigh the potential benefits to the consumer against the perceived risk that it interferes in choice. We should, after all, act on evidence, not perception.