United Benefit Advisors Insight and Analysis Blog

Employer Strategies for Managing Prescription Drug Costs

Posted by: Mary Drueke-Collins, FSA    Jul 20, 2017 9:46:29 AM

Modern medicines have resulted in longer, more productive lives for many of us. Prescription drugs soothe sore muscles after a strenuous workout or manage the conditions of a chronic disease. Unfortunately, this use of prescriptions drugs can come with a hefty price tag.

Americans are spending more money on prescription drugs than ever before and the United States as a nation spends more per capita on prescription drugs than any other country. With the cost of some drugs exceeding thousands of dollars for a 30-day supply, this can translate into financial hardship for many Americans.

Read More

Topics: UBA Health Plan Survey, health plan design, prescription drug cost, prescription drug copays, coinsurance

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.

Read More

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.

Read More

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

Which Employers Are Incentivizing Generic Drugs Over Brand Name?

Posted by: Bill Olson    Aug 4, 2016 10:30:00 AM

According to UBA’s new Special Report – Trends in Prescription Drug Benefits, 61.8% of plans required employees to pay more when they elect brand-name drugs over an available generic drug (a 5.5% increase from 2014); 37.9% of those plans require the added cost even if the physician notes “dispense as written.” On the other hand, only 1% of plans offer no coverage for brand-name drugs if generics are available and 37.2% offer no added cost coverage. So while most employers aren’t completely penalizing those who choose brand-name drugs, more and more plans are requiring employees to pay higher copays when they elect brand-name drugs.

Read More

Topics: UBA Health Plan Survey, prescription drug cost, Scott Deru, prescription drug trends, brand-name vs generic drugs

Mail Order or Not?

Posted by: Mary Delaney, MSPT, CWP    Jul 29, 2016 10:37:19 AM

In 1990, Health Affairs* reported “The escalating costs of prescription drugs and competition among pharmaceutical firms for customers are drawing the attention of policymakers, pharmacies, and individual and institutional purchasers. Mail-order pharmacies recently have grown in prominence as a competitive alternative to the local community pharmacy.”

Read More

Topics: prescription drug cost, mail order drug benefits, prescription drug trends, Brenda Motheral, Mary Delaney

See Which Employers Are Aggressively Increasing Rx Tiers for Cost Savings

Posted by: Bill Olson    Jul 21, 2016 10:30:00 AM

The Latest UBA Survey data shows employers are flocking to two strategies to control rising prescription drug costs: moving to blended copay/coinsurance models vs. copay only, and adding tiers to the prescription drug plans. Almost half (48.9%) of prescription drug plans utilize three tiers (generic, formulary brand, and non-formulary brand), 4.3% retain a two-tier plan, and 44.1% offer four tiers or more. The number of employers offering drug plans with four tiers or more increased 34% from 2014 to 2015. The fourth tier (and additional tiers) pays for biotech drugs, which are the most expensive. By segmenting these drugs into another category with significantly higher copays, employers are able to pass along a little more of the cost of these drugs to employees. Over the last two years, the number of plans with four or more tiers grew 58.1%, making this a rapidly growing strategy to control costs.

Read More

Topics: UBA Health Plan Survey, prescription drug plans, prescription drug cost, benefits cost control, Rx

Industry Trends Emerge in Mail Order Drug Benefits

Posted by: Mary Drueke-Collins, FSA    Jul 8, 2016 11:19:18 AM

Mail order has always been a convenient way for individuals to keep their maintenance drug prescriptions filled. Employers often wonder, are there other advantages to using mail order other than convenience? As an employer, should we be incentivizing mail order? The answers to some of these questions can be found in results from the latest UBA Health Plan Survey.

Read More

Topics: UBA Health Plan Survey, prescription drug plans, prescription drug cost, mail order drug benefits, Mary Drueke-Collins

Employers Split on Whether to Self-Fund Prescription Drug Plans

Posted by: Bill Olson    Jun 30, 2016 10:30:00 AM

On average, 11.9% of prescription plans are self-funded, with the vast majority (88.1%) of employers choosing to fully insure their prescription plans, according to UBA’s new Special Report: Trends in Prescription Drug Benefits, based on data from the latest UBA Health Plan Survey of more than 10,000 employer-sponsored health plans. Although self-funding has increased 9% from the past survey year, the move to self-funding is slow but positive among small groups (10 to 199 employees), while large groups are actually moving away from this model.

Read More

Topics: self-funding, UBA Health Plan Survey, prescription drug plans, prescription drug cost, Scott Deru

Soaring Specialty Pharmacy Drug Prices Leave Consumers Feeling Rather Ill

Posted by: Carol Taylor    Jun 28, 2016 12:31:22 PM

In the early 2000s, prescription costs were around 20 percent of total medical claim spend. This number stayed relatively unchanged for a number of years. Recently, this number has been increasing at an alarming rate.

Read More

Topics: Carol Taylor, UBA Health Plan Survey, prescription drug cost, specialty pharmacy drug prices, medical claim spend, medical claims costs, UBA Special Report

New Drugs for Some ... Will They Ultimately Cost Everyone an Arm and a Leg?

Posted by: Elizabeth Kay    Aug 20, 2015 12:00:00 PM

Advancements in science and technology can be absolutely amazing. The types of treatments that are available now are light years ahead of where we were even 10 years ago. For example, there are some new anti-viral drugs that have become available. One in particular that is for treating Hepatitis C has been very successful. It can actually cure patients of Hepatitis C, in just weeks for some cases.

So why might these drugs not be available to those who could really use them?

Read More

Topics: health care costs, health care reform, Elizabeth Kay, AEIS Advisors, Affordable Care Act, multi-tier pharmacy benefits, prescription drug plans, prescription drug cost