Business Health Insurance

Pharmacy: A Key Benefit for Your Company’s Health

For many employees, prescription medicines can be as vital as the care they receive from their physicians. Medications aid daily efforts to remain healthy, manage symptoms and limit the need for direct medical care, whether employees are dealing with acute illness or suffering from a chronic condition.

With 32 million Americans using three or more medicines daily according to the Pharmaceutical Research and Manufacturers of America (PhRMA), it is clear that medication plays a key role in keeping employees healthy and on the job.

To gain maximum value from your investment in a pharmacy benefit, it must work hand-in-hand with your medical coverage. Here are a few items to be aware of when evaluating pharmacy benefit choices:

  • Generic drugs are comparable to brand-name drugs in important ways including quality, dosage form, performance characteristics and intended use. Using generics can significantly lower prescription medication costs for plan participants.
  • Plan formularies are lists of available medicines for a given pharmacy benefit plan. A quality formulary will include vital drugs for acute and chronic diseases. Drugs are often grouped into tiers, with the cost to the employee (co-pay) determined by the tier in which the medication is placed. Many formularies have three pricing tiers, with generics as the lowest cost option.
  • Specialty drugs are generally high-cost, scientifically engineered drugs that are used to treat complex, chronic conditions.

As companies recognize the value of a pharmacy benefit, many are also learning about the importance of medication adherence by patients; that is, taking drugs on time and in the prescribed dosages. Non-adherence can be as dangerous and costly as many illnesses. According to PhRMA, more than a third of medication-related hospitalizations are related to patients not taking their medicines as directed.

The bottom line? Gaps in medication coverage or poor adherence may lead to higher spending on avoidable treatments. Wise use of proper medicines by employees may help control medical costs while keeping your employees healthy.

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