A new report by the Pharmacy Benefit Management Institute (PBMI) makes some very interesting points about the value of PBMs to employers and employees. Some highlights include:
* PBM generic copays are in line with overall inflation, only increasing from $9.85 to $10.85 over a 15-year period in inflation-adjusted dollars.
* Preferred and non-preferred brand copays (preferred brand from $19.43 to $31.08 and non-preferred from $37.58 to $56.65) have outpaced inflation considerably.
* Plan sponsors increased use of prescription drug benefit deductibles by 157% in 2015 compared to 2014.
* In 2014, only 14% of plan sponsors reported having a deductible for prescription drugs compared to 36% in 2015.
* There is considerable opportunity for employers who are willing to implement additional strategies to control costs and utilization without shifting additional costs to members.
* Mail order in particular can save members an average of over four monthly copayments per prescription per year (annualized). For a member taking a preferred brand in a three-tier plan design, this equates to yearly savings of $138.88 for a single maintenance medication.
The complete report (sponsored by Takeda Pharmaceuticals) can be found here.