Who wins when a copay exceeds the prescription price? Not the patient
Prescription drug copayments often exceed the retail cost of a drug, a recent USC study reveals. This means that technically an overpayment occurs, and someone — not the patient — keeps the excess payment. Researchers at the USC Schaeffer Center for Health Policy & Economics who recently analyzed claims found that the copay exceeds the cost to the insurer in 1 in every 4 claims. The average overpayment is about $7.69. However, almost 1 in 5 overpayments exceeded $10. Karen Van Nuys, a research assistant professor at the USC Price School of Public Policy and executive director of the Schaeffer Center’s life sciences innovation project, was the study’s lead author.