MANY EMPLOYEES REMAIN UNAWARE OF LOWER-COSTING ALTERNATIVES TO THEIR EXISTING MEDICATIONS

An August 2010 survey sponsored by UnitedHealthcare found that most Americans are concerned with their medication costs, but admit that they don’t know how much new prescriptions cost them or if there’s a less expensive option available to them. Consumers being unaware or unfamiliar with generic alternatives and less expensive alternatives means that many are missing a chance to save on their out-of-pocket drug expenses substantially. UnitedHealthcare has estimated that if members with fully insured plans changed to a generic brand or alternative lower-costing option, the result could be a yearly health care savings of more than $1 billion -- $490 million of which would be savings on prescription co-pays.

Other highlights from the study included:

  • Thirty percent of those surveyed admitted that they had not taken or skipped a dose of their routine medications due to the high cost of their prescription.
  • Sixty percent of those surveyed said that they had concerns regarding the cost of their medications. Of those, almost 70% admitted that they often didn’t know the cost of their prescription prior to purchasing it.
  • Yet, when the respondents were asked if they would be willing to switch to a lower-costing 94% answered yes.

The Desire for Information. The survey clearly showed that most Americans purchasing prescription drugs have an interest in learning more about their options, especially lower-costing options. There are several ways that employers can help their employees to understand more comprehensively how much their medications are costing them and discover ways to reduce their out-of-pocket prescription drug spending without compromising the medicinal effectiveness of their medications.

  1. Employers might develop communications tailored to providing plan participants information about saving options, recognizing alternative lower-costing medications to their existing expensive medications, and advice and support on how to pursue other options. This can be in the form of a phone call, email, newsletter, or such.
  2. A co-pay tier system can be very helpful in communicating the differences in value between drugs. The more fiscally and clinically advantageous medications should be placed on the lowest tier. These are the medications that have little, if any, co-payment. Meanwhile, the more expensive medications with higher co-payments should be placed on higher tiers. Plan members will be able to clearly see the difference in how much they pay for their existing medication and how much they could be saving with an equally effective lower-costing option. Seeing the difference in such a comprehensive manner can motivate the employee to consider trying a lower-costing medication option.
  3. Pharmacists can be given specific messaging on what lower-costing and effective options are available to plan participants. As an employee goes to their pharmacy to fill a prescription, the pharmacist will see what alternatives are available at a lower-cost and be able to convey this information to the individual. If the employee feels that a lower-costing medication is desirable, then the pharmacist can contact the doctor that prescribed the medication to approve the change or, in some cases, make the change then and there.
  4. A pill splitting or half-tablet program can reduce employee co-pay on medications by 50%. However, a physician must state on the prescription that the pills are to be halved or split.
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