I'll Vouch for that

Our clinic sample-closet is still stocked thank goodness, with glucose meters and testing supplies. The hospital removed all the medications and placed them centrally in the pharmacy for distribution, so that they “could keep track “ of what was being given out. What a pain, but that is another story…

Amidst the seven different types of meters and their corresponding glucose test strips and lancet devices are small credit card sized coupons—the vouchers. On the surface they seem like regular coupons cut from a newspaper: they are for a certain items and quite specific, they have expiration dates and cannot be doubled etc. However in some ways they are quite different. Many vouchers can only be used by patients with private insurance, and exclude those with Medicare or Medicaid. This of course does not make much sense to me given our population in the clinic, and that holders of private insurance may have more disposable income than those without. This is one of my least favorite aspects of some voucher programs.

Other vouchers enroll patients in programs including dietary planning or glucose tracking, as well as providing discount prices on the testing supplies themselves. This service can be wonderful if taken advantage of in the first place. Which brings me to my point—how useful are these vouchers anyway?

I like the purist altruistic aspect of the vouchers—helping people afford medications and supplies that can be prohibitively expensive. Great idea, no one disagrees there. The addition of services such a dietary guidance sweetens the pot. On the other side of the river there are several arguments against the vouchers, beyond the fact that they are often annoyingly close to their expiration date when delivered to clinic.

There is of course the burgeoning argument that giving out brand-specific vouchers puts the doctors and clinics somewhat more so in the palms of the drug companies Point taken, but when you are faced with a patient who cannot afford supplies there is sometimes little choice, unless the doctor wants to hand over his/her paycheck for all the patients’ medications. Even patient assistance programs in the hospitals are often linked to specific medications and not others.

I am curious to know what percentage of patients actually USE the vouchers given in clinic. In my own, it is less than 30% I am sure. Why? Not sure—perhaps the act of having to make another phone call and potentially stay on the line on hold for an undetermined time is a deterrent. Perhaps folks are concerned about being asked personal information by these companies. I have been given a vouchersmyself and did not use it. Aside from the expiration date being passed (do drug company reps EVER pay attention to this?), I was a bit annoyed that I was given a voucher for a very expensive version of a medication for which instead I could simply have been given a prescription for the generic version. That’s just a peeve of mine, hawking the newfangled expensive lovechild of the initial older version, but the point is that I did not have enough incentive to use the voucher.

Personally, I think vouchers should not have private insurance as a requirement. The numbers of people on Medicare and Medicaid are rising, as are those without any insurance whatsoever. In my opinion they need assistance just as much, if not more.

I think vouchers should not have any expiration date whatsoever. The only expiration date should be on the medication or supply package itself, not the voucher. Limits on amounts, fine. Time limits? No.

Having never called any of these voucher toll-free numbers myself, I do not know how much information they ask of those patients signing up. I assume there is some information gathered for their own market database, but hopefully it is not too intrusive and painful.

Tomorrow I will be going through the vouchers in the cabinet for some of our glucose meters and hoping to find some non-expired vouchers that my patients will use. After they pass from my hand to theirs, who knows where they will end up. Let’s hope these little vouchers fulfill their potential.