HealthLeaders-InterStudy, the leading provider of managed care market intelligence, reports that health insurers in Virginia, Maryland and Washington D.C. (Mid-Atlantic region) are looking to reduce pharma costs. According to the latest Mid-Atlantic Health Plan Analysis, multiple strategies, including tiered pricing, no copays for generic drugs and robotic prescription fulfillment, are being employed to help control pharmacy expenses.
According to the report, average weighted pharmacy expenses for Mid- Atlantic plans rose from $26 to $33 per member, per month from 2004 to 2006. Most large commercial insurers saw their pharmacy costs increase in the Mid- Atlantic anywhere from 8 percent to 14 percent.
Health plans are continuing to experiment with innovative ways to control members' drug costs by focusing on copay waivers, strategies and technology. Atena introduced "Save a Copay," a member incentive that waives the copay for cholesterol-lowering generic drug for six months. CIGNA has its own in-house mail-order operation, CIGNATel-Drug, which is tied to its drug cost comparison tool. By going to myCIGNA.com, members can compare costs of their medications at nearby pharmacies with their personal benefits factored in. Kaiser Permanente offers members the convenience of online ordering and uses robotics at their central fill, which allows them to process prescriptions at high volume.
"Health plans have approached the problem of high drug costs with creative strategies and innovative automation, but ultimately the solution to high costs in healthcare is a strong move toward wellness and prevention," said Jan Shuxteau, market analyst for HealthLeaders-InterStudy. "This is good news for consumers and health plans, especially in areas such as the Mid-Atlantic where pharmacy costs are still rising and the outlook for savings is good."
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