2026年5月7日 美国东部时间早上5:00 / KFF健康新闻
下次去药房时，你可能会收到处方药优惠券。虽然这听起来像是一笔划算的交易——有望省下数百美元——但决定是否接受优惠券并非易事，对有保险的患者来说尤其如此。
据《美国医学会杂志》4月6日发表的一项研究显示，尽管处方药成本持续上涨，但近年来拥有商业保险的患者使用药企赞助的药品优惠券的比例有所下降。
“药企推出的优惠券数量并未减少，但我们仍发现这类商业保险参保人群存在大量负担得起的问题，”该研究的主要作者、乔治城大学卫生管理与政策助理教授姜秀英（So-Yeon Kang）说道。
“患者处于支付方和药企的夹缝和博弈之中，”她表示。
药企通过线上或药房柜台向消费者发放自付额优惠券。这类药企赞助的优惠券与GoodRx等公司的折扣卡服务不同：GoodRx会协商批量压低处方药价格，再将节省的费用转给消费者。
药企发放优惠券的目的是通过为患者提供短期优惠来保持其药品的竞争力。消费者自付费用更少，通常针对的是品牌药。这会促使患者选择品牌药版本，即便市场上已有更便宜的仿制药。
部分保险公司认为这不公平地让他们为更昂贵的药品买单，并表示此举导致月度保费上涨，最终受惩罚的是消费者和患者，而非药企。
那么，当药房提供药企赞助的处方药优惠券时，应该使用吗？
简短的答案是：视情况而定。
以下是需要考虑的五个要点：
1. 如果你没有保险该怎么办？
如果你没有保险，使用优惠券是省钱的好办法，尤其是在该药没有仿制药的情况下。
TrumpRx是一项新的联邦资助项目，相当于面向患者的处方药优惠券平台。部分优惠券来自药企，也有部分并非如此。并非所有药品都有优惠券优惠，但该平台能为符合条件的药品为消费者省钱，短期来看效果尤为明显。
研究患者与消费者保护问题的KFF高级政策经理米歇尔·朗（Michelle Long）表示，没有保险的患者可以通过使用TrumpRx或药企优惠券省钱。（KFF是一家卫生政策研究、民调与新闻机构，旗下包含KFF健康新闻。）
“我不会仅仅因为上面带有特朗普的名字就全盘否定，”朗说道。“对于很多服用特定药物的人来说，确实能省下一笔实实在在的钱。”
不过朗也提到，FDA批准的药品有数千种，而TrumpRx平台仅收录了约85种。需要注意的是，药品优惠券存在限制和使用规则，不会永久有效。当优惠券用完后，没有保险的消费者可能需要全额支付药费。
2. 如果你有商业健康保险该怎么办？
对于有保险的人来说，答案要复杂一些。
如果你的保险计划不覆盖该药品，或者你打算全额自付现金，那么优惠券或许是不错的选择。反之，则需谨慎。
部分药品的保险覆盖范围存在差异，比如GLP-1类减肥药。姜秀英的研究发现，尽管美国减肥药的使用量一直在上升，但商业保险参保者使用优惠券的比例已从2017年的54.6%降至2024年的仅2.5%。
她表示，这反映出随着药价下降，越来越多的患者选择自付现金购买此类药物，同时保险公司不愿为其买单，而药企也将推广重点从发放优惠券转向了营销活动。
3. 如果你预计今年医疗费用会很高该怎么办？
如果你有保险，且预计今年通过就医和治疗将达到免赔额门槛，那么可以考虑使用优惠券。
优惠券能让你在药房买药时减少自付支出，但保险公司通常不会将优惠券的金额计入你的免赔额额度。只有在没有仿制药可选，且你确定即使不使用优惠券也能达到免赔额的情况下，才适合使用优惠券。
4. 如果你有保险但年度医疗总花费较低该怎么办？
答案几乎肯定是：不要使用优惠券。
除非你需要的药品不在保险计划的覆盖范围内，否则使用优惠券会让你面临更高的间接成本。此外，通常将费用用于抵扣免赔额会更划算。
朗表示，要警惕保险公司为阻止患者使用药品优惠券而推出的自付额调整计划，这类计划主要有两种形式：
“‘自付额累积器’允许患者全额使用药品优惠券，但优惠券的金额不会计入患者的免赔额或自付最高限额。这会让患者更难达到保险公司开始承担处方药和其他医疗费用的门槛，还可能导致患者最终需要全额支付药费，因为他们尚未达到年度免赔额。”
“‘自付额最大化器’采用类似的机制，同样不将优惠券金额计入免赔额。最大化计划会通过第三方调整患者全年的自付额，使其与药企优惠券的金额相匹配。”
朗说道，保险公司有时会用“员工储蓄计划”这类委婉的名称向消费者推广这些计划，听起来理论上很不错，但实际上会削弱优惠券的部分价值。
消费者一开始在药房结账时能看到优惠，但从长远来看，最终可能会支付更多费用。
5. 如果你参加了医疗补助计划或医疗保险该怎么办？
医疗补助计划和医疗保险的参保者被禁止使用药企赞助的优惠券。
一项联邦反回扣法规定，为影响他人购买最终将由联邦医保项目支付的商品而提供任何有价值的物品均属违法。该法律还禁止支付报酬，包括免除自付费用以及以低于公平市场价值的价格销售产品。
药企的药品优惠券完全符合这两类禁止情形。
部分州，尤其是加利福尼亚州和马萨诸塞州，在药品有仿制药可用时禁止或限制使用药企优惠券——这凸显了药企、健康计划与政府之间的紧张关系。
_KFF健康新闻_是一家全国性新闻编辑部，专注报道卫生领域深度新闻，是KFF的核心运营项目之一——KFF是独立的卫生政策研究、民调与新闻资讯来源。
That discount at the pharmacy counter may pack hidden costs
May 7, 2026 5:00 AM EDT / KFF Health News
Next time you go to the pharmacy, you might be offered a coupon on your prescription drugs. While it may sound like a great deal — with the prospect of saving hundreds of dollars — the decision to accept it is complicated, especially for people with insurance.
Even as prescription drug costs rise, patients with commercial insurance have slowed their use of manufacturer-sponsored drug coupons in recent years, according to a study published April 6 by the Journal of the American Medical Association.
Manufacturers are offering just as many of them, “but still, we see a lot of affordability issues among this commercially insured population,” said So-Yeon Kang, the study’s main author, who is an assistant professor of health management and policy at Georgetown University.
“Patients are at the intersection and battle place between these payers and manufacturers,” she said.
Drug manufacturers distribute copay coupon cards to consumers online or in person at the pharmacy counter. These manufacturer-sponsored coupons are not the same as discount card services from companies like GoodRx, which negotiate lower bulk pricing for prescription drugs, then pass those savings along to the consumer.
Manufacturers issue the coupons to keep their drugs competitive by offering patients short-term savings. Consumers pay less out-of-pocket, often for brand-name drugs. This encourages patients to use the brand-name version of the drug, even when a cheaper, generic version might be available.
Some insurers say this unfairly puts them on the hook for pricier drugs. They say monthly premiums are higher as a result, punishing consumers and patients, not the manufacturers.
So, should you use manufacturer-sponsored prescription drug coupons when they are offered?
The short answer: It depends.
Here are five things to consider:
1. What if you do not have insurance?
If you are uninsured, using a coupon can be a great way to save money, especially if there is no generic version of the drug.
TrumpRx is a new federally funded initiative that acts as a prescription drug coupon dashboard for patients. Some of the coupons come from manufacturers, while others do not. Not every drug has a coupon offer, but the portal will save consumers money on drugs for those that do, especially in the short term.
Michelle Long, a senior policy manager at KFF who studies patient and consumer protections, said people without insurance can save money by using TrumpRx or manufacturer coupons. (KFF is the health policy research, polling, and news organization that includes KFF Health News.)
“I wouldn’t brush it off entirely because it’s got Trump’s name on it,” Long said. “For a lot of people who take certain medications, there really could be some real savings.”
Still, Long said, TrumpRx lists only about 85 drugs, among thousands approved by the FDA. It is important to note that drug coupons have limitations and guidelines. They do not last forever. When they are exhausted, uninsured consumers may have to pay full price for the drug.
- What if you have commercial health insurance?
For people with insurance, the answer is a little more complicated.
If the drug isn’t covered by your insurance plan or if you intend to pay cash, then the coupon may be the way to go. If not, be wary.
Insurance coverage varies for certain kinds of drugs, such as GLP-1 obesity drugs. Kang’s study found that coupon use by commercial insurance holders on obesity drugs dropped from 54.6% of prescriptions in 2017 to only 2.5% in 2024, even though use of the drugs has been rising in the United States.
She said this reflects the growing number of patients paying cash for the drugs as prices decline, along with insurers’ reluctance to cover them and manufacturers’ shifting focus from coupon distribution to marketing campaigns.
3. What should you do if you expect high medical costs this year?
If you have insurance and anticipate meeting your deductible for the year through health care visits and treatments, consider using the coupons.
Coupons let you pay less out-of-pocket when you visit the pharmacy, but your insurer likely won’t count the value of the coupon toward your deductible. Only use a coupon if there is no generic option available and if you know you’d otherwise hit your deductible.
4. What if you have insurance but low overall medical costs?
The answer will almost always be: Don’t use the coupon.
Unless the drug you are looking for is not covered by your insurance plan, using coupons will put you at risk for higher indirect costs. It’s also often more advantageous to spend toward your deductible.
Watch out for copay adjustment programs that insurers use to discourage the use of drug coupons. They come in two common forms, Long said.
“Copay accumulators” allow the use of drug coupons up to their full value, but the amount of the coupon won’t count toward patients’ deductibles or out-of-pocket maximums. That makes it harder for them to reach the threshold at which insurers will pitch in on prescriptions and other medical care. It can also mean a patient will eventually start paying the full cost of the drug because they haven’t yet met their annual deductible.
“Copay maximizers” use a similar technique that also prevents the coupon value from counting toward deductibles. Maximizer programs use a third-party to adjust patients’ copayments over the course of a year to match the amount of the manufacturers’ coupons.
Insurers sometimes offer the programs to consumers under euphemistic names like “Employee Savings Program” that sound good in theory, but, in reality, take away some of the value of the coupons, Long said.
Initially, consumers will see savings at the pharmacy counter, but they may end up paying more in the long run.
5. What if you’re on Medicaid or Medicare?
Medicare and Medicaid beneficiaries are prohibited from using manufacturer-sponsored coupons.
A federal anti-kickback law makes it illegal to give someone anything of value to influence their decision to purchase something that will ultimately be paid for by a federal health care program. The law also prevents remuneration, which includes waiving copays and charging less than fair-market value for a product.
Manufacturer drug coupons squarely fit within both categories.
Some states, notably California and Massachusetts, prohibit or limit the use of manufacturer drug coupons when a generic version of the drug is available — highlighting the tension among manufacturers, health plans, and the government.
_KFF Health News_is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at_KFF_— the independent source for health policy research, polling, and journalism.