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Tiered Pharmacy Benefit Plans on the Rise
Pharmaceutical Executive
In an effort to cope with soaring healthcare costs, more employers are establishing three-tier prescription drug benefit plans for workers.
In an effort to cope with soaring healthcare costs, more employers are establishing three-tier prescription drug benefit plans for workers. This year, almost 60 percent of workers with health insurance have pharmacy coverage that sets higher cost-sharing formulas for non-preferred medicines, compared with preferred products or generics. That figure is up considerably from the 36 percent of three-tiered plans in 2001 and is double the 29 percent rate in 2000. (See "More Workers Pay More.") The cost of pharmaceuticals within these tiers is also higher: brand-name therapies for which generic substitutes are available now cost consumers an average $26 co-pay per prescription, up from $20 in 2001, according to an annual survey of employer benefit plans conducted by the Kaiser Family Foundation (KFF) and the Health Research and Educational Trust (HRET). A total of 85 percent of workers now are in either two- or three-tiered plans, as more employers take steps to keep prescription drug costs under control.
More Workers Pay More
Beyond the Birthrate: The Societal Costs of Maternal Mortality
September 6th 2024Head of Medical Affairs and Outcomes Research at Organon, Charlotte Owens, MD, FACOG, discusses the most critical changes needed to close the gaps in R&D for maternal health solutions and how feasible they are to make.
