Pharmacy benefits eating up bigger portion of health care budgets

Seventy-seven percent of employers spent 16% or more of their total health care budgets on pharmacy benefits last year, up from 71% in 2013. Nearly 5% of employers, meanwhile, spent more than 30% of their health care budgets on pharmacy, according to a recent prescription drug benefit survey from Buck Consultants at Xerox.

“With specialty drug costs showing no signs of decreasing, we could easily see the average percentage of total health care spend employers are paying for pharmacy increase from 15 to 20%,” says Paul Burns, principal, Buck Consultants at Xerox.

Also see: Specialty drugs present challenges, opportunities for plan sponsors

The average cost of a month’s supply of a specialty drug exceeds $2,500, according to the survey, and the annual cost per course of treatment can be $75,000 or more. Despite these costs, 22% of respondents do not know the portion of overall drug spend attributed to specialty medications.

“Considering the importance of managing specialty drug therapies now and in the future, the percentage of employers not knowing their costs is too high,” says Burns. “I recommend employers analyze specialty drug costs and utilization patterns under both the pharmacy and medical benefits to get a better pulse on this spend.”

The 170 organizations that participated in the survey come from a broad range of industries and represent approximately two million covered lives.

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