According to a recent Kaiser Family Foundation poll, prescription spending accounts for 8 – 10% of overall healthcare spending. With the development of new name-brand drugs and specialty drugs, that trend will continue if it’s not dealt with.
Controlling prescription spending is key to controlling overall plan costs, and in self-funded plans, employers have more power in controlling and actively managing these costs. Here are 3 strategies BMA takes to help employers actively manage and control prescription spending.
- Analytics and Price Transparency
To effectively manage prescription spending, the employer first needs to know where they stand. BMA’s online reports give employers a starting point by illustrating their history in prescription spending and the key cost drivers. Then, we run the employer’s data through analytics to identify lower cost therapeutic alternatives for the members. Through this transparency, employers can identify the key issues and develop a plan for mitigating the costs.
- Defined Formularies
Just as with any form of budgeting, managing prescription spending requires the employer to set limits and parameters for spending. Self-funded plans support this strategy by letting the employer define which drugs are available to the employees under the plan. This allows the employer to promote generics rather than costly name brand drugs and manage spending by distributing high cost drugs in smaller increments. Employers can even be notified if a drug over a certain cost has been requested. All of these tactics enable stronger control over RX spending, while giving the employer and employees the formulary that’s right for them.
- Employee Education
Historically, employees have habitually just used whatever drug their doctor recommends without giving a lot of thought to the costs. In order to better control RX spending, employee education is critical. BMA provides educational materials and support to guide employees in better prescription spending. In addition, our partners even contact the doctor on behalf of the member in order to recommend a lower cost drug for treatment. Through these efforts, employees will become more aware of prescription costs and better equipped to seek more cost-effective drug alternatives.
Successfully managing prescription spending requires analytics and transparency, defined formularies, and employee education. With almost 30 years’ experience in prescription cost management, BMA can help you reach success in controlling and managing your RX costs.
Contact us to learn how you can deliver cost-effective access to drugs that will support your employees’ healthcare needs.