BLS: Participants Pay More of the Prescription Drug Tab

August 31, 2004 (PLANSPONSOR.com) - Employers are looking to shift more of the burden of prescription drug coverage to the workforce as this component of health insurance coverage continues to be extremely volatile.

Since 1993, the number of companies charging $10 of more for prescription drug co-payments has skyrocketed, while companies offering prepaid prescription drug plans has plummeted. In 1993, less than 10% of employers charged more than $10 for a prescription drug co-payment, compared to more than 70% in 2003. Conversely, whereas in 1993 more than 80% of firms offered prepaid plans with copayments under $10, now less than 10% do, according to data aggregated by the Bureau of Labor Statistics (BLS).

During this time, US aggregate spending for prescription drugs more than tripled, thanks in large part to two main factors – rising prices and increasing utilization of prescription drugs – with growing consumption responsible for the bulk of the increase. From 1992 to 2002, the number of prescriptions purchased increased 74% (from 1.9 billion to 3.3 billion), while the US population grew 12%; the average number of prescriptions filled per person per year increased from 7.3 to 11.6.

This is of particular import to plan sponsors, given that more than 93% of private health insurance coverage was obtained through the workplace (from a current or former employer or union) in 2001. Further, among people 18 to 64 years, 82.0 percent of workers had health insurance that year, compared with 74.3% of nonworkers.

Thus, employers are offering more options for participants to obtain their prescriptions. Since 1993, the number of employers with higher reimbursement for generics, network pharmacies and mail order drug outlooks has grown steadily. For example, in 1993, fewer than 30% of all plans offered a higher reimbursement for generics, compared to more than 80% in 2003. Similarly, whereas fewer than three out of 10 employers had mail order solutions in 1993, now more than 70% do.

A copy of the full report is available at http://www.bls.gov/opub/mlr/2004/08/art5full.pdf .

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