Medical claims costs and prescription drug use are projected to decline in 2008, reflecting patients' growing awareness of the need to spend wisely on health care, according to a new survey from The Segal Co.

Segal forecasts continued decreases in per capita claims cost for 2008, marking the fifth consecutive year of declining trends. Most notably, Segal finds that the per capita claims cost for prescription drugs has declined dramatically, by nearly 9%, since a high of 19.5% in 2003.

"The increases in the number of prescriptions are abating," explains Ed Kaplan, national health practice leader for Segal. "There hasn't been a blockbuster drug [introduced] in the last year or so. It's also possible employers' [recent] investment in wellness and disease management has contributed to that [decline]. There's increased market competition, utilization has abated, and plan designs have changed dramatically. Copays and deductibles are higher, and that may be leading to more rational [consumer] buying."

Although use of generic medications is rapidly growing due to patent expirations on brand-name drugs and communication efforts by employers and pharmacy benefit managers, brand-drug drug cost inflation continues to be a major cost-driver due to an ongoing focus on developing and marketing biotech and specialty drugs, Segal reports.

Other key findings include:

• In point-of-service plans and health maintenance organizations, per capita claims cost increases peaked in 2003 for active workers and retirees under age 65 and have declined steadily since then.
• Per capita claims cost increase for dental plans in 2008 is projected to decline modestly from 2007 levels. Fixed-schedule plans and dental maintenance organizations have the lowest forecasted rates.
• For vision plans in 2008, the projected per capita claims cost increase is expected to decline slightly from 2007 levels (to 3.6%).