Employers are effectively controlling drug benefit costs and utilization, according to research findings in the Pharmacy Benefit Management Institute's (PBMI) 2009-2010 Prescription Drug Benefit Cost and Plan Design Report. PBMI's employer survey shows the average rate of increase in drug costs has dropped to 4.4%, the lowest rate of increase since PBMI began conducting the study in 1995.
"Drug benefit management indicators are trending in the right direction as a result of effective use of economic incentives and clinical tools," says Dana H. Felthouse, MBA, PBMI president. "Employer use of multiple-tier drug benefit designs continues to increase for a third year, encouraging plan member use of low cost medications when medically appropriate. Generic dispensing rates increased in both retail and mail, with the average retail rate at 63.5% and the average mail rate at 53.6%."
For the first time, the study notes differences among fully-insured, self-insured, carve-out and carve-in drug benefit programs. For example, self-insured employers and those with carve-out drug plans are most likely to use multi-tiered cost sharing. Another significant difference occurs in management of specialty pharmacy. More carve-out employers than carve-in employers offer a specialty pharmacy benefit, with carve-out employers more likely to use their PBMs as exclusive suppliers of specialty drugs.