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Executive Summary Methodology Profile of Respondents Plan Design Features Cost Sharing Highlights Pharmacy Reimbursement Highlights Drug Cost Highlights Utilization Management Highlights
 

The average annual increase in drug cost expenditures reported in 2007 was 6.9 percent.

The range of drug cost savings was from .01 percent to 21.10 percent. Meanwhile, the range of cost increases was .01 percent to 50 percent. This range is broad because of the varying sizes, plan designs, and clinical programs the survey respondents are using.

Since 2005-2006, generic dispensing rates have increased in both the retail and mail categories (see Table 33). An increase in the difference between first-tier and third-tier retail copayment amounts shows a 5.0 percent increase in retail generic dispensing rates. No increase is seen in mail-service, because not enough employers reported sufficient data to calculate average generic dispensing rates.

Only one employer reported experiencing a $65-or-more difference between first- and third-tier mail copayments.

Tables 36 to 38 report the per-member-per-month (PMPM) utilization metrics for active employees and retirees on the number of scripts, the gross cost of scripts, and the net cost of scripts. As these numbers are reported for the first year, they serve as baseline data.

Eighty-eight percent of the employers who were surveyed shared data about the type and amount of manufacturer rebate arrangements they have negotiated. The rebate amount per retail script ranges from $0.10 to $10.79. The rebate amount per mail script ranges from $0.50 to $45.00 (see Table 39). These numbers also are reported for the first year, and therefore also serve as baseline data.


Table 32: Range of Percentage of Generic Prescriptions Dispensed in Retail and Mail-Service


Table 33: Trends in Average Generic Dispensing Rates


Table 34: Impact of Copayment Difference on Retail Generic Dispensing Rates


Table 35: Impact of Copayment Difference on Mail Generic Dispensing Rates


Table 36: Range of the Number of Scripts Per Member Per Month


Table 37: Range of the Gross Cost of Scripts Per Member Per Month


Table 38: Range of the Net Cost of Scripts Per Member Per Month


Table 39: Range of Rebate Amounts


Decreased Copays Encourage Voluntary Pill Splitting

 

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