There may be a smidgen of good news for companies that worry about the
skyrocketing costs of prescription drugs: Relentless growth rates may be losing
steam. Projected pharmacy-related cost increases for 2006 are in the
neighborhood of 11.8 percent--still a double-digit growth rate that significantly
outpaces the Consumer Price Index, but a far cry from the record levels of 18.3
percent that rocked the U.S. just three years ago, according a recent survey of
70 health care insurers by Aon Consulting.
In fact, this is the first time since Aon began the survey four years ago
that forecasts for pharmaceutical cost growth are lower than the 13 percent
projected for medical expenses. Bill Sharon, senior vice president at Aon,
attributes the slowdown to a potent battle that employers are waging against
ballooning health care expenses. "Employers are at the end of their rope and are
being more aggressive in tackling this issue," Sharon says.
One way employers are trying to rein in costs is by amending their lists of
covered drugs. This process often entails substituting label drugs with
generics, which tend to be less expensive. Furthermore, employers are
strategically identifying drugs that do not treat medical conditions per se but
are widely considered to be lifestyle enhancers, such as Viagra, and changing
their status. Some companies are reducing their financial burden by asking
employees who want to use these drugs to increase their share of co-payments. In
some cases, employers are deciding to exclude lifestyle drugs from the list of
covered medicines altogether.
Companies are also combating exorbitant pharmaceutical expenses by requiring
employees to use mail order to purchase medications for chronic conditions such
as high blood pressure. That tends to cut costs. In addition, employers are
putting the squeeze on their pharmacy benefit managers, who in turn put pressure
on drug manufacturers to drive down prices.
Other factors contributing to the reduced projections in growth rates include
increased usage of consumer-driven health plans and successful implementation of three-tiered co-pay plans that stimulate purchase of generic
drugs. Furthermore, patents on certain drugs are set to expire, which would
expedite their development on a generic, less costly basis, Sharon says. In
spite of the ground that is being gained, there is room for much more
improvement, he explains, adding that 15 percent of total medical-claims
expenses emanate from general pharmacy costs.
—Gina Ruiz