Health Plans Try New Tactics to Spur Generic Drug Utilization
As blockbuster medications lose patent protection this year, some insurers are employing a variety of strategies to boost generic drug uptake — such as waiving copayments for specific drug categories or moving medications that are about to get generic equivalents onto preferred formulary lists with lower copays. But others have shied away from drug-specific tactics and are instead focused on lower copays to encourage generic use.
More than a dozen of the nation's best-selling prescription drugs have lost or are expected to lose patent protection this year through 2010.
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Managed Care.
Nutrition News: Another Reason to Load Up With Veggies
An apple a day might keep the doctor away, but vegetables could be the better defense against memory loss and cognitive decline. Research published today in the journal Neurology found a link between high vegetable consumption and a slower rate of age-related cognitive decline in adults over 65. No such benefit was seen with high levels of fruit intake, and the oldest study participants seemed to reap the biggest advantages. "The older you were and the more vegetables you consumed, the better the benefits," says Martha Claire Morris, epidemiologist at Rush University Medical Center in Chicago and lead study author.
The study's 3,718 participants ranged in age from 65 to 102, with an average age of 74.3. Between 1993 and 2002, cognitive tests and food intake questionnaires were administered in participants' homes, and follow-up interviews were done three and six years after the initial intake.
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U.S. News & World Report.
Consumers Prefer Generics To Brand Drugs
A new Wall Street Journal/Harris Interactive poll indicates consumers’ shopping habits for prescription drugs are likely to change due to the recent decisions by Wal-Mart and Target to sell some generics for $4. Survey responses from 2,493 adults suggests they are more likely to purchase lower-priced generic prescription drugs than brand-name drugs, and that in the future, they are more likely to shop for them at large discount stores like Wal-Mart or Target.
Thirty-nine percent of participants said they currently buy their drugs at a chain drug store, such as CVS or Walgreens, while 13% purchase from a discount store and 12% from a local independent pharmacy. However, half said in the future they would be likely, very likely or “absolutely certain” to fill their prescriptions with generic drugs from discount stores in light of the $4 announcement.
Moreover, nearly a fourth of respondents, 23%, said they would “always choose” to buy generics over the brand name, and 28% said they would “much more often” choose the generic. Only 9% indicated they would always choose the brand name drug over the generic.
A majority of adults, 40%, said they’re willing to pay $10 or less out-of-pocket for a 30-day supply of generic prescription drugs. Thirty-six percent said they would pay between $10 and $25, 15% would pay between $25 and $50 and 5% would be willing to pay more than $50.
Article provided by Benefit News 10-17-06.
Employers Still Feel Pressure Of Medical Costs
Health care costs are projected to rise by 6% in 2007 for U.S. employers, which is two-thirds higher than the Consumer Price Index. Next year’s total health care expenditure is expected to rise by an average of $518 per employee to an average total cost of $8,748. This increase “will exert significant pressure on businesses striving to maintain adequate coverage for their employees,” the consulting firm says.
“While it is good news that 2007 represents the fourth year of declines in the overall average rate of increase, it is definitely not a signal that the pressures are abating or that companies can sit back and expect to continue their downward trend,” says Dave Guilmette, managing director of Towers Perrin's health and welfare practice. Medical costs have increased by over 60% during the past five years, the survey found.
Survey results indicate that employers have succeeded in halting the double-digit cost growth characterized in the late 1990s and early 2000s. Towers Perrin estimates next year's projection would have been closer to 8.5% if employers hadn't aggressively managed their programs.
A separate survey by Buck Consultants also concluded that health care inflation is decelerating. It found that PPO premiums increased 10.9% this year, down from 12.7% last year, and HMO costs grew 10.8% this year, down from 11.8% last year. Prescription drug cost trends are at their lowest level in seven years. They grew 8.2% this year, down from 11.1% last year.
Article provided by BenefitNews, October 3, 2006.
Hearing Benefits Could Be Music To Employee Ears
Every boss has had moments when it seems like he's just not getting through to his employees. When it seems the message is going in one ear and out the other, consider this: It's not that employees aren't listening, they're just not hearing.
Over 31 million people have some degree of hearing loss. More than 80% of the hearing-loss population can improve their condition by being fitted with hearing aids, reports the National Center of Health Statistics.
So, why are hearing plans such a forgotten benefit while dental and vision coverage is considered standard? It could be because employees are reluctant to recognize their diminished hearing or are too sheepish to ask about a benefit.
Employers who raise awareness of hearing problems and implement a hearing benefit could see a major return on investment.
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Hearing Benefits.
Medicare Insurers to Offer More Options in ’07
Medicare beneficiaries will have access to more options for prescription drug coverage in 2007, with many insurers offering better value and a larger number of medications, the Bush administration said Friday. But the potential for confusion may also increase.
The administration said beneficiaries who were satisfied with their current drug coverage would not have to do anything when the six-week open enrollment period begins Nov. 15. Consumer advocates, however, said beneficiaries should carefully review the options because prices have changed, often by significant amounts.
The number of national drug plans offering coverage in every state will rise to 17 next year, from 9 this year. In New York, 61 drug plans will be available, up from 46 this year.
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The New York Times.
CDHPs May Save Money, Maintain Quality Of Care
Consumer-directed health plans result in lower medical costs, maintained or improved levels of chronic and preventive care and increased usage of generic medications and consumer tools, according to a new study from Aetna, which sells consumer-directed health plans.
Aetna President Ronald Williams notes, "The financial results achieved by full replacement plans are particularly significant, equating to a savings of $1 million per 1,000 members over a three-year period while still maintaining quality care." Aetna reviewed four years of data to determine the impact of CDHPs on 1.6 million Aetna members.
Employers that offered Aetna's health reimbursement arrangement experienced an average medical cost trend of 6.7% from 2002 to 2005. Furthermore, patients with chronic conditions in Aetna's HRA and health savings accounts maintained or improved the level of care they received prior to joining the plan. Generic drug utilization for HRA users was 4.5% higher than for PPO members. Meanwhile, Aetna HRA members accessed online tools more than twice as often as members in other plans.
A separate survey from Blue Cross and Blue Shield Association shows the popularity of HSAs is equally distributed across consumers aged 25 to 54, with demand also coming from all education and income levels.
About 46% of HSA users choose HSAs because they consider them less expensive, while 38% of account holders view HSAs as a long-term savings vehicle, and 38% are seeking greater control over their medical expenses, BCBSA indicates.
There's room for improvement in savings rates. Only 57% of HSA-eligible enrollees opened accounts this year, BCBSA reports. However, 52% of Aetna's HSA members rolled over their entire fund last year.
Article provided by Benefitnews, October 5, 2006
Get Set For Another Stick
Parents of healthy preschoolers: Your children need a flu shot. The Centers for Disease Control and Prevention is recommending for the first time that all children from 6 months to 5 years old should be immunized against seasonal flu-and last week, the CDC announced that enough vaccine should be available this year for all comers.
Previously, the agency recommended vaccinating children from 6 months to age 2, recognizing that flu can be deadly in the very young and also that young children spread flu germs far more effectively than adults. Parents, siblings, and baby sitters of young children should also get flu shots, says Daniel Jernigan, deputy director of the CDC's influenza division, particularly since babies under 6 months can't get the shot. And vaccination is particularly important for children who have chronic ailments like asthma, who are much more likely than their peers to be hospitalized with flu complications.
Article provided by U.S. News and World Report, October 8, 2006.
U.S. Shows Improvements In Some Health Services
Many Americans witnessed the quality of their health care improve in recent years, reports the National Committee for Quality Assurance, a Washington DC-based health care advocacy group. “People enrolled in health plans that measure and publicly report performance data were more likely to receive preventive care and have their chronic conditions managed in accordance with clinical guidelines based upon medical evidence,” NCQA's recent report states.
For example, diabetics are more than twice as likely to have their cholesterol controlled to recommended levels today than in 1998. Nearly 77.7% of children enrolled in private health plans received all recommended immunizations in 2005, a 5.2% jump from 2004. More than 96% of patients who suffered a heart attack were prescribed beta-blockers to help prevent a second heart attack last year, up from 62% in 1996.
However, quality gaps remain. For instance, the quality of care for people with mental illness has not improved. NCQA estimates that if the entire health care system performed at the level of the top plans, between 37,600 and 81,000 lives would be saved each year. These quality gaps also lead to over $10 billion in lost productivity and almost 65 million avoidable sick days.
NCQA President Margaret O’Kane says, “The past decade has demonstrated the benefits of measurement, reporting and accountability [on quality measures], but three out of four people don’t enjoy those benefits today. It’s time to ask, 'Why not?'”
Article provided by BenefitNews, October 3, 2006
Group Backs Health Inflation Treatments
The National Business Group on Health yesterday released a series of recommendations for employers seeking to control their medical expenses. NBGH, which represents 250 large employers, recommends these actions:
- stop paying for medical claims related to medical errors,
- require hospitals and health care systems in preferred networks, or groups that receive special financial incentives, to take specific measures to improve health care quality and safety though programs like the 100,000 Lives Campaign and the Surgical Care Improvement Project, and
- encourage hospitals to adopt health IT.
NBGH Preident Helen Darling comments, “There is an urgent need to protect patients, and the lack of meaningful progress in improving safety and quality in the U.S. health system is frustrating to employers that can no longer afford to sustain rising and uncontrollable health care costs."
Harry Spencer, chair of NBGH's board of directors and vice president of global benefits & HR operations at Time Warner, says, “The need for vast systemic improvement in the quality and safety of health care has never been greater.”
Article provided by Benefitnews, October 5, 2006
Taking A Fresh Look At Your Benefits
If you haven't already, you'll soon be getting materials from your employer for your company's open enrollment season – the time when employees look at their benefit choices and determine whether to make any change for 2007.
More than ever, this is an annual fall ritual that you should take seriously because more of the responsibility is being put on employees to fund their health care as companies seek to cut costs in every way they can.
"In this age of 'consumerism,' open enrollment is often the one time of year when employees have the chance to act like true consumers by evaluating their benefits coverage and ensuring that they don't have gaps or costly overlaps in coverage," said physician Ronald Leopold, vice president of MetLife's institutional business.
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Benefits.
Pharmacy Benefit Managers Fading As Generic Drug Use Grows
Pharmacy Benefit Managers (PBMs), hired by employers to manage prescription drug purchasing, have long been criticized for not passing on to clients the rebates they receive from drug manufacturers.
After all, PBMs are in business because they save their clients money.
Recently, many PBMs have agreed to pass along rebates on brand-name drugs to customers. Yet such gains are too little too late, according to some health care benefits experts.
Drug consumption is moving away from brand-name drugs—the source of rebates—and toward generics. From 2005 to 2009, some of the most widely used brand-name drugs, from Allegra to Zocor, have become or will become available as generics. Companies are enticing employees to use the cheaper generic drugs by making co-pays for brand names more expensive.
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Generics.
In Times Of Need: Responding When Grief Strikes
Like an avalanche that spreads quickly across segments of a mountain, grief reaches far across a person’s life. It has performance, productivity, safety and communication implications at work.
It also can impact physical and mental health.
Grief is more than just mourning after a death; it also stems from divorce, job loss, miscarriage, illness, fractured relationships and natural disasters.
“There is a time in everyone’s life when they need some help,” says Gil Stricklin, founder of Marketplace Ministries, which provides chaplains to serve at worksites. “Everybody’s got a problem, just had a problem or is getting ready to have a problem.”
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Mental Health to read this article in its entirety.
