SOURCE: Burchfield Group

March 10, 2008 11:31 ET

Over-the-Counter and New "Behind-the-Counter" Drugs Give Employers More Options for Drug Benefit Plans

As the FDA Adds New Drugs to the Over-the-Counter Class, Plan Sponsors Need to Weigh Their Coverage Options

ST. PAUL, MN--(Marketwire - March 10, 2008) - Traditionally, employer-provided prescription drug coverage focused on just that -- prescription drugs. But as many common prescription drugs, most recently Zyrtec®, become available over the counter without a prescription, employers are increasingly interested in the cost savings associated with over-the-counter (OTC) drugs.

"The increase in the types of drugs available over the counter is really changing employer-provided coverage plans," said Brian Bullock, president and CEO of The Burchfield Group, a consulting firm that helps employers and other plan sponsors control the costs of providing prescription drug benefits. "For employers that want to maintain a good set of benefits and coverage for their employees, the lower costs of many OTC drugs make it relatively painless for an employer's plan to cover those drugs."

Meanwhile, the U.S. Food and Drug Administration is considering the official establishment of a third class of drugs, referred to as "behind-the-counter" (BTC) drugs. These drugs are available without a prescription but only through direct contact -- and perhaps a brief consultation -- with a pharmacist.

When deciding how to handle OTC and BTC drugs, employers need to consider a variety of variables, including members' current drug usage and the company's goals for coverage and costs. The BTC classification is still unsettled territory, so the current focus is on developing effective approaches to managing coverage for the two existing categories of OTC and prescription drugs.

"Employers have three general approaches for how to handle OTC drugs," said Cory Belken, a senior consultant at The Burchfield Group and, like Bullock, also a pharmacist. "As OTC drugs become a larger part of their members' usage habits, employers can simply leave their plans alone and some utilization will naturally migrate to OTC drugs. They can also restrict the use of prescription drugs in a particular category to encourage OTC use, or they can implement a 'step therapy' plan that requires patients to first use OTC drugs when appropriate before moving to prescription drugs."

To learn more about employers' options for OTC and BTC drug coverage, listen to the most recent installment of the Pharmacy Benefits Podcast. The free audio program, available at www.burchfieldgroup.com, features a discussion between Bullock and Belken on plan sponsors' options and factors to consider. Employers interested in learning more about potential savings from OTC drugs can request a free overview report from The Burchfield Group by sending an e-mail to info@burchfieldgroup.com or by calling 1-800-778-1359.

About The Burchfield Group

The Burchfield Group is a pharmacy benefit management consultancy based in St. Paul, Minn. The Burchfield Group brings innovative perspectives to managing pharmacy benefits, helping plan sponsors evaluate and select pharmacy benefit management (PBM) vendors, designing pharmacy benefit plans, monitoring plan and PBM performance, and auditing results. Their staff of experts has a vast knowledge of the PBM industry, including insight into drug manufacturers' influences, mail service profits, and retail network margins. (www.burchfieldgroup.com)

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