Many patients continue to struggle with the costs of pharmaceutical products. For patients with chronic diseases, pharmaceutical costs are an unremitting expense. Nonadherence related to the cost of pharmaceutical agents is a major public health issue. This nonadherence is associated with increased hospitalizations and adverse health effects such as increased risk for stroke and acute myocardial infarction.1,2 Although Medicare Part D has decreased cost barriers to obtaining medications, 20% of Medicare beneficiaries in fair or poor health report cost-related nonadherence.3 Enhanced adherence is an important strategy to improve health outcomes. Drug coupons that discount patient co-pays have emerged as a popular tool to decrease the financial burden of prescription drugs. From 2009 to 2011, the number of drug manufacturer coupons increased markedly, to an estimated 340 individual drug coupon programs.4
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