Thursday, August 22, 2019

Employers Target Prescription Plans to Save Costs

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Soaring health costs from hospital stays, emergency room charges and doctor's appointments -- costs that often are out of employers' control -- all give sponsors of benefit plans plenty to worry about these days.

Fortunately, many employers are making a real impact in one area that is increasingly important when figuring total health costs: prescription drugs.

A new report by the Pharmacy Benefit Management Institute notes that employers are actively taking measures to shore up and control their prescription drug benefits with some success, according to Human Resource Executive Online.

Specialty drugs -- high-cost medicines that can reach hundreds of thousands of dollars annually for a single patient -- have become a main target, the report notes. While copays for generics and traditional drugs have remained stable, specialty copays increased 37 percent between 2010 and 2011 and are expected to jump more in the future.

Although only about 3 percent of employees take these types of drugs, the prescriptions account for as much as 15 percent of overall drug costs, Doug Ghertner, president of Change Healthcare, told HREO.

Some other emerging strategies include:

More Cost-Sharing
Making employees aware of the real cost of prescriptions can influence behavior and persuade workers to use cheaper generics, Ghertner said. Cost-sharing drives home the value of the benefit for employees and can lead to better decisions at the pharmacy counter, he said.

Drug Adherence
Patients who don't take their medicines properly can create more health problems down the road, experts say. Joshua Brenner, a doctor of pharmacy, noted at a recent industry summit in Washington, D.C., that guidance directly from a pharmacist or health professional can significantly boost drug adherence. In a report by Drug Topics magazine, Brenner said personalized communications and targeting high-risk patients for nonadherence also is key.

More employers are exploring the idea of merging the prescription portions of their group health and worker's compensation programs to better manage drug safety and costs, according to a report in Business Insurance.

Although this strategy offers a number of challenges -- such as the disconnect between federal and state laws -- the savings can be worth the work because pharmacy benefit management integration can offer a comprehensive view of a workforce's prescription drug use, Rich Leonardo of Express Scripts told the magazine. This information leads to better management of the benefit, especially on the workers' comp side, Leonardo said.

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