Changes to flexible spending accounts; High co-pays prompt abandoned prescriptions

Minnesota Public Radio: "[T]he federal health care reform law is cutting back on what [flexible spending] accounts will cover and how much workers can put into them. … These two changes are designed to raise more tax revenue to help pay for insuring another 32 million Americans beginning in 2014. The Congressional Budget Office and Joint Committee on Taxation estimate these changes will allow the government to raise about $19 billion between now and 2019. … But the change could have some unintended consequences, [health economist Jean] Abraham said. Relatively few employees use these accounts, but many of them who do suffer from chronic illnesses and rely heavily on the accounts" (Stawicki, 11/15).

The Associated Press/Boston Globe : "A headache awaits people who use those tax-free health spending accounts to pay for over-the-counter allergy relievers, heartburn blockers, and other drugstore remedies. Starting next year, you will need a prescription for the drugs to qualify. The change in so-called flexible spending accounts is part of the new health care law, and doctors are bracing for patient confusion and annoyance as they decide how to handle prescription requests for products that people normally use on their own" (Neergaard, 11/16).

BusinessWeek/HealthDay: Meanwhile, a new study explores the impact of co-payments on prescription drug use. Just more than 3 percent of prescriptions are left unclaimed at pharmacies, which "adds up to about $500 million in additional health care costs annually," according to a study published in the Annals of Internal Medicine that looked at "more than 10.3 million prescriptions. … Cost appeared to be the biggest driver in whether or not someone would leave a prescription, according to the study. If a co-pay was $50 or over, people were 4.5 times more likely to abandon the prescription, [lead author William] Shrank said, adding that it's 'imperative to talk to your doctor and pharmacist to try to identify less expensive options, rather than abandoning an expensive medication and going without.' Drugs with a co-pay of less than $10 were abandoned just 1.4 percent of the time, according to the study (Gordon, 11/15).