AdvancePCS, an Irving, Texas-based health plan services provider, said its clients spent 10.3% more on prescription drugs in 2003 than the year before, compared with a national average spending hike of 13.4% as estimated by the Center for Medicare and Medicaid Services. AdvancePCS clients’ 2003 drug spending increases ranged from 3.3% to 10.9%, according to a company news release.
Among the reasons for the drug–spending trend, according to the company:
- a three-tiered plan design, which sets a co-payment or coinsurance payment for each drug classification (generics, preferred brands, nonpreferred brands)
- formulary management, which encourages the prescribing of lower-cost, therapeutically appropriate drugs
- specialty pharmacy management, offering a single distribution source for this high-cost drug spend category coupled with pharmacy benefit management-based electronic claims processing and clinical care
- generic incentive programs, encouraging members to try lower-cost, clinically appropriate generic medications
- mail pharmacy utilization, designed to improve member health through home delivery of maintenance medications with savings for clients and patients alike
- utilization management, which reduces unnecessary drug use by helping to ensure that drugs are used appropriately and in compliance with prescribed instructions by patients who require them.
For more information, go to www.advancepcs.com .