Prescription drug prices continue to rise.
This leaves employers and employees alike in a challenging position.
For employers, the challenge is balancing cost and service to their employees. For employees, especially those in need of so-called specialty drugs, which can treat life-threatening and life-altering conditions such as hepatitis C, the challenge is being able to afford this necessary care.
This is easier said than done.
According to insurer UnitedHealth Group, U.S. spending on specialty drugs could reach $400 billion by 2020. And another major insurer, Cigna, reports that overall pharmaceutical costs will rise 10 percent this year, with specialty drug spending a major factor in the increase.
So how can companies and their employees manage the prescription drug spend? By following best practices, including:
-- Going through an insurance carrier’s pharmacy benefit manager for specialty drugs. Pharmacy benefit managers sometimes have the ability to negotiate better rates for these pricey-but-essential drugs.
-- Companies may require employees to get smaller supplies of drugs to reduce cost and waste. For instance, a 30-day supply is surely preferable to a 90-day supply.
-- Firms could add another “tier” of drug pricing for specialty drugs, with increased co-pay or co-insurance requirement for employees with an eye on ensuring the cost is shared between both parties.
-- Similarly, companies should have procedures in place to ensure that employees — when possible — explore other treatment options before being given specialty drugs. However, this isn’t applicable in cases of life-threatening diseases that can be combated with a lone specialty drug.
Ultimately, rising drug costs leave firms and employees should push both sides to a place of greater understanding of the challenges ahead. Employees deserve the utmost care and respect, but all parties must be cognizant of the ways to ensure medical spending is both prudent and fair. For more information and strategies on how to combat rising prescription prices or any other insurance questions, contact an employee benefits client service team member at 847-307-6100 (Deer Park, Ill.), 312-606-4800 (Chicago), 972-770-5010 (Dallas) or 405-840-3033 (Oklahoma City), or contact us via the Web. We’re here to help — and happy to help.