Exclusive Interview with the Researcher: So-Yeon Kang on Manufacturer-Sponsored Coupon Use for Brand-Name Drugs

Interview on Manufacturer-Sponsored Coupon Use for Brand-Name Drugs

Manufacturer-sponsored coupons are commonly used in the US to lower out-of-pocket costs for brand-name prescription drugs. While these coupons can reduce patient costs at the point of sale, they may also weaken incentives and competition, including by encouraging the use of more expensive drugs when cheaper alternatives may be available. A recent study, conducted by So-Yeon Kang, PhD, MBA, and team examined trends in manufacturer-sponsored coupon use and patient out-of-pocket spending. Learn more about this recent JAMA publication and the implications of its findings in an exclusive interview with Dr. So-Yeon Kang.

Q: What surprised you most about trends in coupon usage?

A: The most striking finding was the simultaneous decline in coupon prevalence and intensity. Overall use fell from 18% of commercially insured patients in 2017 to 14% in 2024; among coupon users, the share of pharmacy claims covered by coupons per patient dropped from 14% to 8%. Yet the median coupon amount increased. Together, these patterns suggest manufacturers may be concentrating support on fewer patients while offering larger subsidies. Therapeutic-area variation was also notable: coupon use declined sharply for obesity and diabetes therapies while increasing substantially for immunomodulators.

Q: Why are these findings significant for policy discussions on drug costs?

A: Manufacturer coupons have long been a source of debate. They can reduce patients' out-of-pocket costs at the pharmacy counter, but some research suggests they may weaken formulary incentives designed to encourage cost-effective therapies. Our findings come at a time when copay accumulator programs are expanding, and states are adopting different approaches to regulating them. Understanding how coupon use is changing is an important context for ongoing discussions about how to protect patient affordability without distorting market incentives.

Q: What implications might these findings have for adherence, utilization, and healthcare costs?

A: Coupons are concentrated in a subset of patients and in earlier prescription fills. If patients use coupons for drugs on higher cost-sharing tiers without fully understanding the temporary nature of these programs, they may face substantially higher out-of-pocket costs once support ends. Prior research has also suggested that coupon use may be associated with more frequent drug switching and higher drug spending. Understanding these potential downstream effects will become increasingly important as benefit designs and coupon programs continue to evolve.

Q: What should policymakers and health care leaders take away from this analysis?

A: Manufacturer-sponsored coupon programs appear to be changing rather than disappearing, becoming more targeted and more valuable per use. Policymakers and health care leaders should recognize that evolving benefit designs, copay accumulator programs, and affordability policies shape how financial assistance is distributed across patients and therapies. Future research should examine whether these changes affect medication access, treatment patterns, and overall drug spending, as well as whether accumulator program design can reduce market distortions while maintaining patient affordability.