A significant majority of employers exclude coverage of investigational drugs, hair growth treatment, over-the-counter (OTC) drugs and weight loss/gain products as shown in Table 28. More than half (54%) of employers now exclude non-sedating antihistamines with 40% excluding PPIs, both figures representing significant increases from 2010. Thirty percent of self-insured employers excluded Proton Pump Inhibitors (PPIs), compared to 52% of fully insured. Carve-in employers were more likely to exclude PPIs, as were small employers (p<.05). Fully insured, carve-in and smaller employers were also more likely to exclude nonsedating antihistamines (p<.05) and most other drug classes. In conjunction with the wellness movement, fewer employers are excluding coverage of smoking cessation and weight loss products.
Download Full Prescription Drug Benefit Cost and Plan Design Report or Request Print Copies