Behind the counter, january 2006

1st Quarter 2012
Prescription Drug Use
The average percentage of claims that are filled as Higher in Obese People
generics is 70 percent. The potential is about 85 percent, however, so further opportunity exists. A new survey from the Centers of Disease Control and Almost 60 percent of employers cover 90-day Prevention (CDC) found that obese adults in the Unites supplies of maintenance medications at retail States used prescription drugs more frequently than 30 percent of employers require specialty Ten different drugs classes were analyzed, and use among medications to be dispensed through their PBM’s obese adults was higher in eight of the 10 medication types. High blood pressure and high cholesterol Plan design changes such as these increase the need for medications had the highest use among obese people as effective plan member education. Giving employees compared to adults of a normal weight. Other medication resources to make smarter choices and seek lower cost types included those for treating diabetes, asthma, thyroid alternatives will help support employee satisfaction and problems, depression and pain. Obese individuals were also more likely to be on multiple medications at once. Researchers concluded that the results were not terribly surprising, as obesity puts people at increased risk for Specialty Drugs Often a
medical conditions such as heart disease, diabetes, stroke Mystery for Employers
Implementing health and wellness initiatives is a great Despite the fact that specialty drugs are a major cost driver opportunity to address this high utilization among obese of pharmacy benefits, 25 percent of employers have little or no understanding of specialty pharmacy, according to a Midwest Business Group on Health survey. In addition, the vast majority of respondents did not know Shifting Rx Plan Designs
how much their company was spending on specialty Attempt to Manage Costs
Beyond the higher costs of specialty drugs, these Plan sponsors are adopting various plan design changes in medications present other challenges to patients, doctors an effort to manage prescription drug costs, according to a and pharmacies, such as special approvals needed and Pharmacy Benefit Management Institute survey. Key unique dosing instructions. Addressing the cost and other factors associated with specialty medications can be a Plans using a four-tier plan design increased from Some employers are implementing different plan designs Specialty drug copays within four-tier plan designs specifically for specialty drugs, such as incentives to increased 37 percent (from $61 in 2010 to $84 in ensure proper compliance to the medication or value-based First-Time Generics
Drospirenone and ethinyl estradiol Ocella, Yaz, others Behind The Counter, 1st Quarter 2012 2011 Zywave, Inc. All rights reserved.

Source: http://www.eisadvantage.net/Images/Compliance/1Q%202012%20Behind%20the%20Counter.pdf