Buck Bond Group

No End in Sight: Many Employers Now Spending 30% of Healthcare Budget on Pharmacy Benefits

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New research from Conduent shows that twice as many companies as last year are spending upwards of 30% of their healthcare budget on pharmacy benefits. The 2017 Prescription Drug Benefit Survey Report not only reaffirms the rising costs, it uncovered the surprise finding that 20% of companies are not even tracking their pharmacy benefit expenses.

“Overall, many plan sponsors are concerned that their pharmacy benefit program is not as cost-effective as it could be.” – Anna Goldbeck, Principal, National Pharmacy Practice.

For companies and employees, the pharmacy benefit is a cornerstone of any comprehensive health care program. Attracting and retaining employees while managing pharmacy benefit costs in a rapidly changing employer marketplace and pharmaceutical landscape is essential to long-term success. Through an understanding of competitive market survey data, the pharmacy benefit survey helps uncover trends, identifies survival tactics and gives plan sponsors tools to make complex decisions supported by data.

The survey explores key areas of interest to benefits professional and offers strategies to help manage pharmacy benefit spending while keeping an eye on marketplace trends like specialty/biological products and participant cost-sharing strategies. Individual sections are dedicated to topics such as understanding how organizations are addressing key pharmacy-specific requirements in ACA, and the different coverage options available for Medicare-eligible participants.

Highlights from the survey findings include:

  • Employee Satisfaction and Managing Medical Benefit Claims Costs were the first and second most influential decision-making factors regarding the pharmacy benefit.
  • Customer Service and Pricing Competitiveness were both selected as being Extremely Important, by the same percentage of survey respondents. The first instance of a tie in the history of our survey.
  • Results imply that plan sponsors continue to adopt UM programs while using caution about further increasing the dollar spread between cost-share tiers and investing in programs with the potential for longer-term payoffs (e.g., programs that may increase medication adherence and address “gaps in care”)
  • Plans utilizing a pharmacy-only deductible jumped from 30% to 46%, reaffirming the increase in pushing costs down to the plan participant level.
  • Following the trend, specialty pharmacy costs continue to consume a larger and larger percentage of the dollars spent on the prescription benefit.

Overall, many plan sponsors are concerned that their pharmacy benefit program is not as cost-effective as it could be. It’s not an unfounded concern because when not managed effectively, prescription drugs can represent a constant financial drain on company resources that undermines the return on investment of a plan sponsor’s entire health care benefit program. Formulating a realistic strategy for covering prescription drugs is essential to meet an employer’s philosophical and budgetary needs.

Learn more about the Conduent 2017 Prescription Drug Benefit Survey and stop by next week to see our accompanying 2017 Prescription Drug Benefit Survey infographic.