Not a Member?  Become One Today!

Survey Finds Acceptance of Prescription Deductibles, Networks
Pharmacy benefit managers weigh cost-containment features

By Stephen Miller, CEBS  3/26/2013

Consumers appear amenable to their pharmacy coverage mirroring their medical benefits when it comes to deductibles and networks, according to a national survey of 2,765 Americans by pharmacy benefit manager Express Scripts.

The majority of those surveyed, and particularly the long-term uninsured, were willing to pay a $100 deductible for prescription drugs. While deductibles are common for medical insurance, they are not usually found in drug benefit plans.

The November 2012 poll also found that many consumers are open to an in-network and out-of-network pharmacy system, similar to the network-based approach used in medical care, which would require higher co-payments for medications purchased at pharmacies that are not part of the plan’s preferred network.

The survey revealed “a definite shift in consumers’ mindset around their prescription drug benefit,” said Julie Huppert, vice president for health care reform at Express Scripts. “No matter what their current insurance status, most people surveyed appear willing to accept a drug plan that utilizes cost-saving strategies that are commonplace within medical insurance.”

As government subsidies neutralize premiums for low-income Americans purchasing coverage on public exchanges, “factors such as pharmacy network, formulary and co-payment amounts can influence plan choice more heavily,” Huppert added. “In the exchanges, there will be no one-size-fits-all offering.”

Stephen Miller, CEBS, is an online editor/manager for SHRM.

Related Articles:

Employers Reducing Prescription Drug Coverage, SHRM Online Benefits, October 2011

Specialty Drugs Driving Pharmacy Benefit Costs, SHRM Online Benefits, April 2011

Most Still Uninformed About Prescription Drug Costs, SHRM Online Benefits, December 2010

Brand-Name Drug Costs Soar; Generics Hold the Line, SHRM Online Benefits, April 2009

Quick Links:

SHRM Online Benefits page

SHRM Online Health Care Reform Resource Page 

Keep up with the latest news. Sign up for SHRM’s free Compensation & Benefits e-newsletter

Copyright Image Obtain reuse/copying permission