The average annual increase in drug cost expenditures reported in 2008 was 4.86%. The range of drug cost savings was .03% to 25%, while the range of cost increases was .01% to 23%. This range is broad because of the varying sizes, plan designs, and clinical programs used by the survey respondents.

Generic dispensing rates have increased in both retail and mail since 2007 as shown in Table 38. An analysis in the difference between first- and third-tier retail cost sharing does not support anecdotal information that a greater difference between the two amounts will increase generic dispensing.

Per member per month (PMPM) utilization metrics for active employees and retirees on the number of scripts, gross cost of scripts, and net cost of scripts are reported in Tables 41 to 43. The data points are averages calculated from all survey responses so as a result, several net costs in Table 43 are higher than gross costs in Table 42.

Eighty-four percent of employers shared data about the type and amount of manufacturer rebate arrangements they have negotiated. The ranges of rebate amounts are shown in Table 44. Although the average rebate amounts are higher in 2008, the average size group responding is larger and may have more market clout to increase rebate per claim amounts.