April 10, 2006. Today, the Prescription Access Litigation Project (PAL)—a project of Community Catalyst—joined with 22 other consumer advocacy groups in calling for the Food and Drug Administration (FDA) to ban pharmaceutical companies from using so-called drug coupons in their vast direct-to-consumer advertising promotions.  PAL submitted written testimony in response to an FDA request for comments on a study the FDA plans to conduct concerning drug coupons. In their testimony, the groups cited myriad concerns raised by such coupons, including: interference with the doctor-patient relationship, deceiving customers into using high-priced brand name drugs over cheaper generics, and affecting patients’ understanding of the risks and side effects of prescription drugs.

“Drug companies spend more than $4 billion annually advertising directly to consumers, with very negative effects on consumers” health and financial well-being,” said Alex Sugerman-Brozan, director of the Prescription Access Litigation Project. “Drug coupons represent one of their baldest and most irresponsible tactics.”

Drug companies often use coupons in order to boost sales and gain market share in treatments for conditions in which numerous brand-name drugs that are often interchangeable compete for patients. Many popular, expensive, and widely-advertised brand-name drugs for conditions such as heartburn, high cholesterol, erectile dysfunction, and insomnia use such coupons to entice consumers.  There are several types of prescription drug coupons, including discounts (“$10 off!”), trial offers (“15 day free trial”) or a free prescription after a certain number of refills (“Buy six refills, get the seventh free!”).  Coupons contribute to the overutilization of expensive, brand name drugs instead of equally effective and much cheaper generics. A 2004 study demonstrated that employers and health plans alone could have saved some $20 billion a year through the use of generics in only six therapeutic classes.

“Drug coupons make consumers think they’re getting a great deal,” commented Sugerman-Brozan. “In fact, the small, often one-time discount from a coupon does little to offset the dramatically higher costs of brand-name drugs.  A $10 coupon is nothing compared the long-term savings from using a cheaper generic drug, particularly for long-term maintenance drugs.”

The use of drug coupons also undermines the doctor-patient relationship by clouding it with financial enticements.  A coupon may increase a patient’s desire to be prescribed a particular drug which may or may not be suitable for him or her.  Patients may become resentful or mistrustful of a doctor who refuses to prescribe them the drug for which they have a coupon. 

“Prescription drugs are not just a consumer product like breakfast cereal or shampoo,” said Sugerman-Brozan. “But using coupons to sell drugs treats them like they are. Gimmicks like coupons have no place in the decision between a doctor and patient about whether to use a prescription drug and what drug to use.”

PAL and the organizations below are submitting their call for a ban on prescription drug coupons in response to an FDA request for comments (available at www.fda.gov/ohrms/dockets/dockets/06n0029/06n-0029-n000001.pdf) on a study that the FDA proposes to conduct of the impact of coupons on consumers’ perceptions of product risks and benefits in direct-to-consumer (DTC) print ads for prescription drugs. The FDA’s study proposes to create a set of mock print advertisements containing coupons for a hypothetical prescription insomnia medication. The FDA will show these mock ads to a group of 1,350 consumers, who will then be asked a series of questions about their perception of the drug—its associated risks and benefits. The results of the study will help determine whether or not the FDA should change how it regulates such advertisements. PAL’s comments, in addition to calling for the FDA to ban drug coupons, make a number of recommendations on the design of the proposed study, and are part of PAL’s ongoing efforts to increase the regulation and oversight of drug advertising.

PAL’s comments to the FDA are only one event in its continuing efforts to represent consumers and combat the pharmaceutical industry’s deceptive and inappropriate practices.  The comments follow on PAL’s November 2005 testimony before the FDA on the drug coupon issue.  On Wednesday 26 April at 2 p.m. Eastern, PAL will present its second annual Bitter Pill Awards (www.bitterpillawards.org).  The awards were launched last year as a parody of industry trade group PhRMA’s own awards ceremony to pat itself on the back for its often questionable direct-to-consumer marketing activities.  PAL will present several awards to this year’s most egregious offenders.  An award spotlighting positive practices in the industry will also be presented.

PAL is joined in its call for a ban on Rx drug coupons by:

  • Action Alliance for Senior Citizens (Philadelphia, PA)
  • American Federation of State, County and Municipal Employees (AFSCME) (Washington, DC)
  • The Annie Appleseed Project (Delray Beach, FL)
  • Connecticut Citizens Action Group (Hartford, CT)
  • Congress of California Seniors (Sacramento, CA)
  • Consumers for Affordable Health Care Coalition (Augusta, ME)
  • Consumers Union (Washington, DC)
  • Gray Panthers California (Sacramento, CA)
  • Health Care for All (Boston, MA)
  • JPAC for Older Adults (New York, NY)
  • Long Island Health Access Monitoring Project (Great Neck, NY)
  • Massachusetts Breast Cancer Coalition (Quincy, MA)
  • MassPIRG (Boston, MA)
  • Massachusetts Senior Action Coalition
  • Metro New York Health Care for All Campaign  (New York, NY)
  • Minnesota Senior Federation (St. Paul, MN)
  • New York Statewide Senior Action Council (Albany, NY)
  • Tennessee Health Care Campaign (Nashville, TN)
  • United Senior Action of Indiana  (Indianapolis, IN)
  • Utica/Central New York Citizens in Action (Utica, NY)
  • U.S. PIRG (Washington, DC)
  • Wisconsin Citizen Action (Madison, WI)