Brace yourself for soaring drug spending costs—and feel free to blame Obamacare.
A HealthPocket study finds that copayments and co-insurance fees for drugs increased an average of 34 percent under the Patient Protection and Affordable Care Act. And enrollees who use brand-name drugs and specialty drugs are getting hit much harder with rising costs.
That was the finding after researchers examined new PPACA health plans from 46 states and compared the prices to those from the pre-PPACA individual insurance market.
According to HealthPocket, a company that provides health plan comparisons to consumers, all of the four new health plan categories under the law saw drug cost-sharing increases. Bronze health insurance plans saw the highest increase, 58 percent, while platinum health insurance plans had the lowest increase, 15 percent.
Researchers broke down the price differences pre- and post-reform by drug category, and there are some discrepancies. For example, generic drug copays increased 42 percent in a bronze plan, but decreased by 36 percent for enrollees in a platinum plan.
But increases were seen in all PPACA plan levels for generic drug co-insurance fees and specialty drug copays. In fact, specialty copays were huge across the board: The average price pre-reform ($58.46) increased a whopping 226 percent for a bronze plan, 185 percent for a silver plan, 170 percent for a gold plan and 116 percent for a platinum plan.
But researchers still made sure to note that the law has been somewhat beneficial to the prescription drug market.
“The legislation created an expansion of the drug benefit for the individual market and small group market inasmuch as all non-grandfathered health plans must include a prescription drug benefit,” HealthPocket's report read. “Subsidies on health insurance premiums also result in some portion of the previously uninsured being able to enroll in a health plan containing a drug benefit. Additionally, a few over-the-counter drugs such as aspirin, folic acid, and iron supplements can be obtained without a copayment when used as preventive medicine.”
Finally, enrollees who use drugs infrequently “may not notice the cost-sharing increases,” it said.
Complete your profile to continue reading and get FREE access to BenefitsPRO, part of your ALM digital membership.
Your access to unlimited BenefitsPRO content isn’t changing.
Once you are an ALM digital member, you’ll receive:
- Breaking benefits news and analysis, on-site and via our newsletters and custom alerts
- Educational webcasts, white papers, and ebooks from industry thought leaders
- Critical converage of the property casualty insurance and financial advisory markets on our other ALM sites, PropertyCasualty360 and ThinkAdvisor
Already have an account? Sign In Now
© 2024 ALM Global, LLC, All Rights Reserved. Request academic re-use from www.copyright.com. All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.