_This is a post in a series of articles I'm writing called "5 points & 1 resource" (think tl;dr but 5p;1r), where I summarize a list of 5 concepts that would have helped me start learning or re-learning a certain topic. It is intentionally far from a complete source of data._

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I recently came by this **one reference** on the nuances between an individual, their insurance plan and a drug company from an article titled *["Is My Drug Copay Coupon a Form of Charity — Or a Bribe?"](https://kffhealthnews.org/news/article/drug-companies-copay-assistance-program-charity-or-bribe/amp/). *I thought it was important enough to be summarized in 5 points below.

- **Pharma releases a super expensive drug**. While R&D costs are high, the pricing of brand name drugs is still disproportionately high compared to their generic alternatives.

- **Insurance companies set a high co-pay**. Insurance companies set co-pays not only to reduce their own costs but also to encourage the use of drugs that favor generics without sacrificing for quality.

- **Pharma pays the copay on behalf of the individual**. To incentivize individuals to select the expensive brand name option, pharma offers financial assistance or copay cards (copay coupons) to reduce or eliminate the individual's out-of-pocket cost.

- **Insurance gets a big bill**. With the individual leaning towards the brand name drug due to reduced out-of-pocket expenses, the insurance company bears the remaining high cost of the drug.

- **Pharma gets a tax write-off**. Pharma gets a charitable tax write-off for the copay coupon It's important to note that this is nuanced, and not all copay assistance programs qualify, and can vary by jurisdiction and insurance type or plan.