SOURCE: Pharmacy Benefit Management Institute (PBMI)

Pharmacy Benefit Management Institute (PBMI)

December 14, 2015 10:30 ET

PBMI Survey Shows Employers Continue to Face Uphill Battle With Rising Drug Costs

PBMI Releases 2015-2016 Drug Benefit Report

PLANO, TX--(Marketwired - Dec 14, 2015) - Last year marked a dramatic increase in medication cost trend for employers according to The Pharmacy Benefit Management Institute's (PBMI) fifteenth annual Drug Benefit Report released today. Traditional prescription trend increased from 2.4% to 6.2% and specialty trend increased from 12.2% to 19.2%. Cost increases were likely driven by utilization of specialty medications, especially new drugs to treat conditions such as hepatitis C, as well as overall price inflation. The report includes responses from 302 employers representing 16.3 million members.

"We are pleased to release the next version of our Drug Benefit Report which highlights the fact that employers continue to struggle to meet the challenges of rising drug costs," says Jane Lutz, Executive Director of PBMI. "With the patent cliff and generic cost savings opportunities behind us, employers are forced to take a more creative, targeted approach to be more prepared for the pipeline filled with higher cost medications." 

Key findings from the report include:

  • Cost-sharing has become more complex and targeted over the past five to ten years. Four-tier structures were used by 28% of respondents, compared with 8% in 2008.
  • Although average retail 30 copay amounts for generics and preferred brands remain stable, preferred brand copay amounts have approximately doubled in the last 15 years from $37.58 to $56.65, adjusted for inflation.
  • Use of pharmacy only deductibles increased 157% in 2015 compared to 2014 and 36% of plan sponsors now report having a deductible for prescription drugs compared to 14% last year.
  • When appropriate, opportunities exist for plans to implement strategies that decrease out-of-pocket (OOP) costs for members through increased use of mandatory mail order or retail 90 for maintenance medications.

PBMI will host a free, live webinar on December 16 at 1:30 pm EST to showcase the results of this report. Register today. To request a printed copy or download a copy of this report click here.

About PBMI
The Pharmacy Benefit Management Institute provides research and education to help health care and benefits professionals work with pharmacy benefit managers to design prescription drug benefit programs. Learn more at www.pbmi.com.  

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