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Many thought that the low costs of generic drugs would decrease the co-pays for formulary and non-formulary prescription drugs. Yet, new research shows formulary and non-formulary co-pays have increase by at least 20% on all plan types over the last five years.
Analyzing more than 5,400 benefit plans, Compdata Surveys, a compensation and benefits survey data provider, found formulary co-pays were more than $24.00 on all plan types with PPO plans having the highest co-pay, $25.31.
Moreover, the surveys found prices on non-formulary co-pays were above $39.00 for all plan types, and the average co-pay on PPO plans was $42.31.
Since 2003, formulary co-pays on all plan types have jumped by at least 24%, with indemnity plans seeing the largest increase (30.4%), followed by HMOs (27.5%). PPO plans, however, had the smallest increase (24.6%), the data indicates.
While non-formulary drugs on HMO plans had a 20.1% increase over the last five years, other plan types had growth above 27%. For instance, indemnity plans had the highest increase at 36%, while PPO and POS plans faced an upsurge of 27.6% and 27.7%, respectively. The research on prescription co-pays covered almost 6 million employees.
Analysts at Compdata report generic prescription co-pay costs range between $10.56 and $11.25, while generic co-pays on PPO plans are $10.99.
When comparing the generic price to the non-formulary price on PPO plans, analysts saw a difference of $31.32. For prescriptions used monthly, the difference can equate to $375.84 for just one prescription over the course of a year.
"Employers should be proactive in educating employees regarding prescription costs," says Amy Kaminski, manager of marketing programs for Compdata Surveys. "Offering a formulary list to your employees allows them to see how drugs are classified, so they can make informed choices when working with their physician," she adds.
Great statistics, but the bigger question is compliance. How can it be that 70% of the hypertension is NOT under control in the US?
Maybe it's time to readdress prescription copays with compliance in mind instead of the minute cost shift taking place.
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