The survey captured copayment and coinsurance amounts on six drug categories (Generics, Preferred Brands, Nonpreferred Brands, Brands, Lifestyle, and Specialty Drugs) for retail and mail prescriptions. Respondents had the opportunity to write in “other” categories to track the emergence of newly defined tiers. No newly defined tiers emerged this year. In addition to providing average amounts of copayments and coinsurance, the range with low, median, and high points is reported to give drug benefit decision makers actionable information for setting cost sharing amounts.
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 paid a greater percentage of retail costs than mail-service costs. On average, members paid 25.2% of a retail prescription and 19.2% of a mail prescription. These numbers show no change since 2008. Table 11 illustrates the range of claim cost paid by members.
Review more findings about:
Find more detailed, segment-specific data in Cost Sharing Tables
.
Download Full Prescription Drug Benefit Cost and Plan Design Report or Request Print Copies