How can USI help our company gain better control of our pharmacy benefit costs?
USI pharmacy and benefit consultants evaluate current prescription drug trends used in carriers’ forecasting assumptions. Adjusting a plan’s copay structure can drive plan savings and lead to more efficient drug utilization, as members are likely to choose drugs with lower copays when possible.
The most common tiers are generic, formulary, non-formulary, and specialty. Tiered prescription copays incentivize members to choose prescription drugs with lower copays when possible.
We’ve estimated the financial impact for you. Feel free to update the assumptions.
- Supports a proactive employee health and wellness strategy
- Provides additional transparency on plan participants' pharmacy utilization
- Can reduce total plan costs by approximately 2%
Adding copay tiers to your organization’s pharmacy benefit plan – specifically for generic, formulary, non-formulary, and specialty drugs – can significantly reduce plan costs while also improving participants’ management of their pharmacy spending.
Given rapidly increasing pharmacy costs, regular copay adjustments are necessary to maintain a balanced cost-sharing arrangement between your organization and its benefit plan participants. With the proper communication strategy, plan participants will likely recognize the financial value of utilizing lower-cost prescription drugs when available.
While the plan controls the potential savings and levels of copays or coinsurance, the pharmacy benefit manager determines what drugs are “preferred.”
I’d like to explore further how USI can help our company gain better control of our pharmacy benefit costs.
We will need to collect just a few pieces of information from your organization, including a detailed pharmacy plan design, a utilization report of pharmacy claims, and a recent pharmacy audit report, if available.