If you’re a human resources department leader, making the right benefit choices for your business can feel daunting and isolating. That’s why we surveyed your peers across the country and asked them to share their pharmacy benefit issues and opinions. We’ve compiled insights from more than 600 decision-makers in employee benefits, insurance, and human resources to help you understand the top five pharmacy benefit trends on the minds of employers. These insights can assist you in determining how your pharmacy benefit plans stack up against others nationwide.
#1: 93% of employers considered switching pharmacy benefit providers in the last year.
You wouldn’t be alone if you requested proposals for your pharmacy benefits plan this year. The rising cost of prescriptions and complicated pharmacy benefit manager contracts were the top reasons for plan sponsors looking to switch. However, most of your peers didn’t elect to replace their pharmacy benefit partner due to concerns over managing through the change. Don’t let the threat of change hold your plan back from necessary updates that frequently result in improved employee satisfaction.
#2: Smaller employers are more likely to re-evaluate pharmacy benefits plans annually than very large employers (47% vs 9%). A certain amount of nimbleness is inherent in having fewer members and fewer decision-makers in an organization. It can be tempting to let your pharmacy benefits remain stagnant, but this strategy will result in paying non-competitive rates and leaving savings on the table. The savings opportunity is often greatest for those currently in a traditional 3-year pharmacy benefit contract. Ensure your benefit advisor conducts a market check each year to keep your plan spend as low as possible.
#3: Rising premium and specialty drug costs are the top concerns for benefits decision-makers. Providing members with comprehensive benefits can be challenging due to increased costs from premiums and specialty medications. No wonder pharmacy choices keep decision-makers up at night with more than 160 drugs that can potentially top $250K in annual costs. Smart plan design choices can eliminate wasteful spending, protecting your budget while providing members the care they need. Solutions to mitigate risk, like supplemental stop loss coverage, can protect the plan from high-cost drugs when members need them.
#4: Half of employers consider themselves very knowledgeable about pharmacy benefits.
As specialty drug costs increase the impact of pharmacy on a benefit plan’s overall cost, it’s essential to become informed about the latest industry changes and challenges. If you’re not already keeping up with news articles and thought leadership on pharmacy benefits, seek out this information from reliable sources. A few examples are your benefit advisor, trusted human resources experts such as BenefitsPRO and SHRM, and pharmacy-specific thought leaders like RxBenefits.
#5: 90% of employers are somewhat to very concerned about the impact of future regulations on pharmacy benefit plan design. With multiple hearings and dozens of proposed bills, federal lawmakers are looking hard at pharmacy benefit managers and the cost of medications in the U.S. There’s palpable concern over the impact of possible regulations on the ability to offer cost-effective benefits from the leaders we surveyed. In addition to understanding the industry, the key to success is staying informed about the latest proposed laws and making your voice as a plan sponsor heard when changes are proposed.
To navigate the constantly evolving pharmacy benefits industry, employers can lean on their peers, benefit advisors, and trusted benefit partners to find the guidance and support they need. By following these insights and leveraging the right resources, employers can make more informed decisions about their pharmacy benefit plans and earn the trust of their employees.
Ready to plan next year’s benefits package? Ask your benefit advisor these five questions.