December 2016

Drug Coupons. Let’s Cut It Out!

Pharmaceutical company pricing and coupon loyalty programs are a significant factor in why drug spend is expected to be the number one contributor of total health care spend by 2017 – above professional medical and urgent care spend.1 In general, coupons – which are often applied at point of sale but as a transaction separate from the benefit transaction – circumvent employer pharmacy benefit and formulary strategies by removing the incentive for customers to use the most cost effective alternatives. To affectively curb the rising costs of prescription drugs, pharmacy benefit designs and formulary strategies must be vigilant, active and sometimes surgical.  

Guiding customers away from the glitz
Brand-name medications cost more. Drug coupons don’t change that; they simply reduce what customers pay. The remaining cost of the drug is paid by the employer. Coupons for drugs in classes with generic alternatives drive up costs for everyone. At Cigna, we make a number of options available to assist in combating coupons.

  • Low net drug cost strategy
    Drug Cost per brand drug Cost of alternative in Cigna's formulary
    Jublia $734 $40
    Zovirax $1,798 $86
    Pennsaid $1,900 $100
    Glumetza $6,000 $100
    Novacort $3,548 $12
    • We manage our formularies toward the lowest net drug cost for our clients.  Removing expensive (often coupon-assisted) drugs from formularies while still offering access to therapeutic alternatives – often generics.  Here are just a few examples of how we help our clients see significantly lower drug claims costs through our formulary strategy. Each of the drugs listed on the left have a manufacturer sponsored coupon which could reduce the member copay significantly but cost the employer a great deal more.  In 2016, Cigna's formulary strategy decreased trend by a full 2 - 3%.1
    • Example used for illustrative purposes only. Actual costs will vary.
  • Utilization management programs - at no additional cost to our clients
    • Cigna continues to expand the use of prior authorization, step therapy and generics-first programs to ensure the employer does not pay more than the clinically appropriate alternative.  This approach helps significantly reduce the impact of coupon drugs on clients and offers customers access to cost effective alternatives.
  • Cigna Home Delivery PharmacySM
    • To help keep overall pharmacy benefit costs lower, Cigna Home Delivery Pharmacy no longer accepts coupons to fill non-Specialty maintenance medications. We continue to accept coupons for Specialty medications.
  • Cigna Specialty Pharmacy ServicesSM supports several co-pay assistance programs. We have several medication-specific operational processes for advising customers on financial support options based on the pharma manufacturer’s offerings. These processes allow for holistic support for the customer, where the pharma manufacturer and Cigna function as a team to ensure customers are given the personalized level of support needed.


  1. Cigna book of business analysis 2016.