Two-thirds of U.S. employers continue to be concerned about the affordability of prescription drugs for their active employees and retirees, as shown in Figure 16. Figure 17 illustrates the steps employers report they are taking to make prescription drugs more affordable. Among those concerned about affordability, 64% are focusing on plan member education. Plan design changes, improved management strategies, and keeping cost sharing amounts the same also are strategies being used by a large percentage of employers.
Employers establish drug plan designs to share some portion of drug costs with members, usually based on an amount for each tier or drug category. Members are paying a significantly lower percentage for specialty prescriptions than other drugs dispensed at retail or mail. On average, members paid 24.7% of a retail 30 prescription, 24.9% of a retail 90 prescription, 19.3% of a mail prescription, and 16.5% of a specialty pharmacy prescription. The retail and mail-service numbers showed little movement since 2008. This is only the second year that PBMI has collected data on specialty pharmacy, which also showed little change. Table 7 illustrates the range in the percentage of claim cost paid by members.
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