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Prescription drug manufacturers returning money

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Shoppers are used to money back guarantees for everything from razors to toilet paper. But consumer products aren’t the only things now offering purchase protection. (Source: 3TV/CBS 5) Shoppers are used to money back guarantees for everything from razors to toilet paper. But consumer products aren’t the only things now offering purchase protection. (Source: 3TV/CBS 5)
“Money back guarantees for drugs is a relatively new phenomenon,“ according to Mark Fendrick, M.D., Director of University of Michigan Center for Value Based Insurance Design. (Source: 3TV/CBS 5) “Money back guarantees for drugs is a relatively new phenomenon,“ according to Mark Fendrick, M.D., Director of University of Michigan Center for Value Based Insurance Design. (Source: 3TV/CBS 5)
(3 ON YOUR SIDE) -

Shoppers are used to money back guarantees for everything from razors to toilet paper. But consumer products aren’t the only things now offering purchase protection.

Did you know that your health plan may be getting reimbursements for some of the medications you take?

“Money back guarantees for drugs is a relatively new phenomenon,“ according to Mark Fendrick, M.D., Director of University of Michigan Center for Value Based Insurance Design.

Some prescription drugs now promise to perform or the manufacturer, or pharmacy benefit company will provide a discount or refund.

Before you get too excited, though, Dr. Fendrick says, in most cases, the refunds don’t go directly to patients.

“In the early situations, most of the time the money goes back to the health plan or the employer,” he says.

One example: Cigna says it has entered into “value-based contracts” for medications designed to treat conditions such as heart failure and multiple sclerosis. There are agreed upon health metrics to measure whether a drug meets expectations.

Under some contracts, if a drug doesn’t perform as expected, the manufacturer will reduce the cost to Cigna’s benefit plans.

The company says these deals “align financial terms to measured improvements in customers’ health.”

David Mitchell of “Patients for Affordable Drugs” says the guarantees are little comfort to sick patients: “A: Money-back guarantees don’t work because it allows the manufacturer to keep control of the price of the drug. And B: No drug should be given to people if they are not effective to begin with and the FDA determines that.”

Dr. Fendrick says, in some cases, guarantees won’t directly impact patient costs, but they are supposed to help insurers keep premiums from going up.

“It’s increasing accountability and transparency for drugs and drug effectiveness.”

Novartis, which makes some drugs that offer rebates and guarantees says, “By collaborating with payers on outcome based contracting solutions, we hope to help drive a shift toward value pricing in the healthcare system.”

Express-Scripts offers its own guarantees and tells us its Hepatitis-C program has lowered the cost of the treatment to payers by nearly 50 percent since 2015 and has granted 50,000 patients access to care that may be rationed by some providers.

Mitchell, a cancer patient himself, feels there’s a better way, adding, “Let’s just lower the price at the outset.”

To find out if a medication you are taking offers guarantees and to ask what is being done with any potential refunds, call your insurance provider. Dr. Fendrick believes as the guarantees become more common, patients will get a piece of the refund pie.

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Copyright 2017 KPHO/KTVK (KPHO Broadcasting Corporation). All rights reserved.


Gary HarperGary Harper is the senior consumer and investigative reporter for 3 On Your Side at KTVK-TV.

Click to learn more about Gary.

Gary Harper
3 On Your Side

With more than 20 years of television experience, Gary has established himself as a leader in the industry when it comes to assisting viewers and resolving their consumer-related issues. His passion and enthusiasm have helped him earn an Emmy for Best Consumer Reporter from the National Academy of Television Arts and Sciences. He’s also garnered several Emmy nominations

He has negotiated resolutions with companies of all sizes, including some of the biggest corporations in the nation.

Gary has successfully recouped more than $1 million for viewers around the state, making 3 On Your Side one of the most popular segments on KTVK and the station's Web site.

He's best known for investigating and confronting unscrupulous contractors. In fact, many of his news reports have led to police investigations and jail time for those who were caught. Viewers, as well as the companies and people he investigates, regard him as consistently being thorough and fair.

Gary has been with KTVK-TV since 1997. Prior to his arrival in Phoenix, he worked for WZZM-TV in Grand Rapids, Michigan, where he was as an anchor and reporter.

Gary is from Chicago, but launched his television career in Lubbock, Texas, after earning a broadcast journalism degree from Texas Tech University. Following his graduation, he was quickly hired by KLBK-TV in Lubbock, where he enterprised and broke numerous exclusive reports. His aggressive reporting in Texas helped garner him Best Reporter by the Associated Press.

Gary has been married since 1994 and is the proud father of two sons. When he's not helping viewers, Gary is busy catching up on his favorite college and professional football teams as well as cheering on his beloved Texas Tech Red Raiders.

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