United Benefit Advisors Insight and Analysis Blog

Solving the Prescription Puzzle

Posted by: Mary Delaney, MSPT, CWP    Jan 24, 2017 9:30:00 AM

Determining how an employer develops the most effective formulary, while protecting the financial stability of the plan, is certainly the challenge of this decade. Prescription management used to mean monitoring that the right people are taking medications to control their disease while creating strategies to move them from brand name to generic medications. With the dawn of specialty medications, formulary management has become a game of maximizing the pass-through of rebates, creating the best prior authorization strategies and tiering of benefits to create some barrier to more expensive medications, all without becoming too disruptive.

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Topics: UBA Health Plan Survey, multi-tier prescription drug plans, prescription drug cost, Vital Incite, mail order drug benefits, health care cost containment, disease management, Mary Delaney, prescription management

Prescription Drug Copay Trends: Five-Tier Plan Benchmarks Emerge, Large Employers Hike Rates in Three-Tier Plans

Posted by: Bill Olson    Aug 16, 2016 10:30:00 AM

UBA’s Special Report – Trends in Prescription Drug Benefits explores our Health Plan Survey findings in more detail, particularly examining what’s happening with prescription drug plan design among different group sizes, regions and industries. When it comes to copay amounts, median retail prescription drug copays are $10/$30 for two-tier plans, $10/$35/$55 for three-tier plans, and $10/$35/$60/$100 for four-tier plans. These amounts have remained largely flat from 2014.

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Topics: UBA Health Plan Survey, multi-tier prescription drug plans, prescription drug cost, prescription drug trends, prescription drug copays

Pharmacy Copays in Upper Tiers on the Rise, Coinsurance on the Rise

Posted by: Bill Olson    Aug 11, 2015 12:00:00 PM

PrescriptionUBA recently released new pharmacy data from the 2014 UBA Health Plan Survey which shows a significant increase in the use of 4-tier plans. UBA also released the findings related to pharmacy copay design. Not surprisingly, the majority (67.8 percent) of prescription drug plans utilize copays.

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Topics: pharmacy benefits, UBA Health Plan Survey, multi-tier prescription drug plans, pharmacy copays, health plan trends, health plan design

Employers Use of Multi-Tier Pharmacy Benefits Continues to Rise

Posted by: Bill Olson    Aug 3, 2015 4:50:30 PM

Most employers have been using multi-tier prescription drug plans for many years, but new data released from the 2014 UBA Health Plan Survey shows a significant increase in the use of 4-tier plans, which typically cover the highest cost drugs, as well as major increases in corresponding median copays – a trend that is expected to continue.

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Topics: pharmacy benefits, UBA Health Plan Survey, prescription drug plans, multi-tier prescription drug plans