Pharmacy benefits

Medicalization of aging comes at a cost

Prescription medications for age-related conditions such as hair loss and mental alertness have been steadily increasing in cost, says benefit manager Express Scripts, surpassed only both those for diabetes and high cholesterol.

Andrea Davis
By Andrea Davis
Editor-in-Chief
Employee Benefit News

Battling PBM costs

As CEO of United Benefit Advisors, I hear continually about the issues facing our 36,000 employer clients. Managing prescription drug costs continues to be paramount. The UBA 2012 Health Plan Survey shows that 64.2% of prescription drug plans utilize three co-pay tiers (generic, formulary brand, and non-formulary brand); 2.9% have a one-tier plan, 8.2% retain a two-tier plan; and 24.7% add a fourth tier (specialty). Consultants should watch these plan structures carefully as many brand-name drugs go off their patents and pricing is determined for the influx of generic drugs. On the other end of the spectrum, we're watching increases in specialty drugs, which are driving up costs significantly.

Thom Mangan
By Thom Mangan
CEO
United Benefit Advisors

Redesigning benefits

For decades, health care consumers have been told once you have a problem, then you should go to the doctor. But now, as high-deductible health plans become ever more prevalent, employers are encouraging employees to go to the doctor first – before they get sick – and in turn the employer will often cover the visit at 100%.

Brian M. Kalish
By Brian M. Kalish
Online Managing Editor, Health Care Group
SourceMedia

Employees fight physicians on Rx adherence

Patients who don't take their medication as prescribed is a billion-dollar problem, reports pharmacy benefit manager Express Scripts in its 2011 Drug Trend Report. Nonadherence to prescription medication cost the U.S. health care system $317.4 billion in 2011. And that's just for treating medical complications – not the cost of lost productivity – that could have been avoided if patients had taken their medication as prescribed. The report shows that for many therapy classes, less than 50% of patients take their medication as prescribed.

Andrea Davis
By Andrea Davis
Editor-in-Chief
Employee Benefit News

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