To control the costs of prescription drug plans, more employers are focusing on cost sharing and low-price generic drugs, according to Buck Consultants’ second annual “Prescription Drug Benefit Survey.”
The HR consulting firm completed the survey in July 2009, questioning more than 140 U.S.-based employers representing a broad range of industries and employer sizes.
“While the cost of prescription drug coverage varies widely, 30%, or the largest group of respondents, said pharmacy benefits represent between 11% and 15% of total health care costs,” says Michael Jacobs, a principal and national clinical practice leader at Buck Consultants. “This is down from last year’s survey, when the largest group indicated their drug benefits made up between 16 % and 20% of total health care costs,” he adds. The decrease may stem from more expensive brand medications moving off-patent and being replaced by lower-cost generics.
About 76% of respondents use employee cost sharing as a utilization management tool, up from 51% in 2008, Buck’s analysts found. The most common target cost-sharing range is 11% to 20% of claim costs, which was used by 39% of employers.
Overall, employers viewed their prescription drug benefits as a way to keep their workers healthy and to stay competitive in the marketplace.
The survey showed, however, that employers are not fully leveraging low-cost generic pricing as a cost management tool. For example, 73% of respondents report taking advantage of low-cost generic pricing offered by retail pharmacy chains as a high priority, while only 26% require their mail service provider to match these low-cost retail generic prices, Jacobs says.
Employers are also paying more attention to controlling the costs of specialty drugs. Nearly 60% of employers have included adherence to clinical guidelines as part of their specialty drug management programs. Based on the survey’s results, the top priorities in managing specialty drug therapies are:
- Adherence to clinical guidelines
- Clinical management
- Coordination with case managers
- Centralized distribution
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