Pharmacy Benefits will Look Different in the Future
There is a new direction and emphasis in health insurance these days and that is letting employees know the real cost of benefits instead of the copays they have come to expect. The pharmacy benefit may be moving away from copays and toward coinsurance and deductibles.
At the center of new pharmacy benefit models are attempts to change behavior by making us aware of the actual cost of drugs and giving us an opportunity to make our own choices. The future may include an Rx allowance with deductibles vs. copays. The future may show that instead of copays and formularies, we will have access to Web sites that show costs for retail, mail order, generic, brand drugs, and therapeutic equivalents. The results hoped for are fewer prescriptions, choosing generics over branded drugs and mail order delivery instead of retail purchases.
The challenge is that employers and employees have different views on health coverage. Many employers are asking employees to play a greater role in restraining cost increases in part by shifting premium and deductible costs to them in the hope they will change behavior patterns. Recent surveys show that workers are resisting those efforts and finding them not appropriate.
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