PBMI | Prescription Drug Benefit Cost and Plan Design

› Profile of Respondents

› Plan Design Features

› Plan Design Configurations

› Retail Copayments

› Retail Coinsurance

› Mail Copayments

› Mail Coinsurance

› Pharmacy Reimbursement Highlights

› Drug Cost Highlights

› Per Member Per Month Metrics

› Manufacturer Rebate Arrangements

› Drug Inclusions and Exclusions

› Utilization Management Tools

› Trends at a Glance

• View Figures, By Topic

Profile of Respondents
Table 1	Reported Plan Types
Table 2	Actual Count of Number of Members
Table 3	Average Size Group by Number of Members
Table 4	Employers Grouped by Number of Members
Table 5	Resources Used by Employers for Plan Design
Table 6	Percentage of Employers by Job Responsibility Focused on Drug Benefits
Plan Design Features
Table 7	Dispensing Arrangements for Specialty Pharmacy Benefit
Table 8	Strategies for Coordinating with Medicare Part D
Plan Design Configurations
Table 9	Range of Percentage of Claim Cost Paid by Beneficiaries in Retail & Mail Service
Table 10	Configurations of Common Plan Design
Table 11	Summary of Cost Sharing for Common Plan Configurations
Table 12	Two-Tier Plan Designs with Dollar Copayments
Table 13	Two-Tier Plan Designs with Coinsurance
Table 14	Three-Tier Plan Designs with Dollar Copayments
Table 15	Three-Tier Plan Designs with Coinsurance
Table 16	Four-Tier Plan Designs with Dollar Copayments
Table 17	Four-Tier Plan Designs with Coinsurance
Retail Copayments
Table 18	Range of Retail Copayments by Drug Category
Table 19	Average Retail Copayment Amounts by Drug Category for all Employers
Table 20	Trends in Average Retail Copayment Amounts for All Employers
Retail Coinsurance
Table 21	Summary of Ranges of Retail Coinsurance by Drug Category for All Employers
Table 22	Summary of Average Retail Coinsurance by Drug Category for All Employers
Mail Copayments
Table 23	Range of Mail Copayments by Drug Category
Table 24	Average Mail Copayment Amounts by Drug Category for All Employers
Table 25	Trends in Average Mail-service Copayment Amounts for All Employers
Mail Coinsurance
Table 26	Summary of Range of Mail Coinsurance by Drug Category for All Employers
Table 27	Summary of Average Mail Coinsurance by Drug Category for All Employers
Pharmacy Reimbursement Highlights
Table 28	Average Pharmacy Reimbursement By Dispensing Channel
Table 29	Trends in Retail Brand Reimbursement
Table 30	Trends in Mail-Service Brand Reimbursement
Table 31	Average Mail-service Pharmacy Reimbursement
Drug Cost Highlights
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
Per Member Per Month Metrics
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
Manufacturer Rebate Arrangements
Table 39	Range of Rebate Amounts
Drug Inclusions and Exclusions
Table 40	Drug Exclusions
Table 41	Types of Coverage Limitations for Included Drug Treatments
Utilization Management Tools
Table 42	Summary of Utilization Management Tools
Trends at a Glance The trend information released each year in the Prescription Drug Benefit Cost and Plan Design Report
Table 43	Retail Brand Reimbursement
Table 44	Mail-Service Brand Reimbursement
Table 45	Average Retail Copayment Amounts for All Employers
Table 46	Average Mail Service Copayment Amounts for All Employers
Table 47	Average Generic Utilization

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