Employers Count on Workers to Help Control Pharmacy Benefit Costs

August 12, 2008 (PLANSPONSOR.com) - The success of pharmacy benefit cost management strategies cited by respondents to a survey from Buck Consultants will depend largely in part on employee involvement.

According to a Buck press release, the most important clinical management steps employers are taking to control pharmacy benefit costs are disease management, care management, and smoking cessation programs. The top strategic initiatives for long-term cost management cited by respondents include:

  • Providing employees with tools and information,
  • Providing employee education, and
  • Worksite wellness and health activities.

Specialty Medications

While Michael Jacobs, a principal at Buck Consultants, says the emergence of new, very expensive specialty medications is one of the trends driving employers to review their cost management strategies, 28% of survey respondents did not know their relative spend on these expensive drugs. Fifty-two percent of survey respondents said they believe specialty medications represent 10% or less of their total pharmacy costs.

Almost all (99%) respondents to Buck's survey said they provide prescription drug coverage as part of their health care program for active employees. Employers cite the health of employees and business competitiveness as the most important reasons for providing this coverage, according to the press release.

Fifty-one percent of respondents indicated they use employee cost sharing as a utilization management tool, with the most common cost-sharing range being 21% to 30% (used by 44% of respondents).

According to Jacobs, more than one-third (37%) of respondents said pharmacy benefits represent between 16% and 20% of total health care costs, and another 29% reported pharmacy benefits are more than 21% of total health plan costs.

"Easy pharmacy network access" and "comprehensive formulary" were cited as the top strengths of respondents' pharmacy benefits programs, and "complete disclosure of manufacturer revenue" and "complete disclosure of all costs" were cited as major weaknesses.

Buck's survey report, "Understanding Your Strategies for Coping with the Changing Pharmacy Benefit Landscape," is available for $100 from Buck's Global Survey Resources, 500 Plaza Drive, Secaucus, NJ, 07096-1533, or by calling 800-887-0509, or by ordering online at www.bucksurveys.com .