Overpaying For Prescription Drugs: The Copay Clawback Phenomenon
Saturday, June 14, 2014
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Prescription drug overpayments (also known equally “clawbacks”) spill out when commercially insured patients’ copayments piece of employment past times the total toll of the drug to their insurer or chemist's produce goodness manager. While the practise has been acknowledged too discussed inward the media, it has never been quantified inward large samples.
In 2013, near i quarter of filled chemist's prescriptions (23%) involved a patient copayment that exceeded the average reimbursement paid past times the insurer past times to a greater extent than than $2.00. Among these overpayment claims, the average overpayment is $7.69.
Overpayments are to a greater extent than probable on claims for generic versus construct drugs (28% vs. 6%), simply the average size of the overpayment on generic claims is smaller ($7.32 vs. $13.46). In 2013, total overpayments amounted to $135 1000000 inward our sample, or $10.51 per covered life.
With over 200 1000000 Americans commercially insured inward 2013, these findings advise the practise of overpayments may concern human relationship for a non-negligible percentage of overall drug spending too patient out-of-pocket costs.
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