Are free copay
programs the solution to controlling escalating healthcare costs?
Her study of the health records of more than 93,000 statin users in employer-sponsored health plans demonstrated that higher copays
were associated with significantly lower medication adherence, which in turn was linked to more emergency department visits and cardiovascular hospitalizations.
In the past, the plan has offered a two-tiered benefit, with lower copays
for generics and higher copays
for brand-name drugs.
As we approach 2013, many pharmaceutical companies are reviewing their copay
card programs, and making decisions regarding whether to continue, discontinue or modify them," says Mohan Purushothaman, executive vice president at ALSCG.
Who said that the copay
will be 20%, it might be 30%.
While a copay
plan is not a consumer-directed product, a HSA certainly is--it encourages people to save for future medical expenses, and through the planning process they'll think about how they're spending their health care dollars.
are now $20 to $50 in many plans, not the $5 they once were.
Until now, little was known about these copay
offset programs, since data on coupon and PAP use are frequently not collected by pharmacy benefit managers.
The first tier features the lowest copay
with brand and generic drugs; the second tier has more expensive brand-name drugs and generics; the third tier is primarily brands with lower-cost equivalent drugs in the first two tiers and has a higher copay
; and the fourth tier is reserved for fewer than 1% of all drugs prescribed, such as biotech and new drugs on the market.
The amount owed is equal to the total of the agreed-to-pay amount minus the copay
(unless the copay
is in addition to the agreed-to-pay fee) minus the risk pool deduction.
lt; < < < Plan Provision < < < < Median Office Visit Copay
< < < < $20 Specialist Office Visit < < < < $30 Inpatient Hospital Copay
< < < < $250 ER Copay
< < < < $75 Infertility Treatment Co-insurance < < < < 50%
Analyses show that the re-imposition of a copay
would cause a substantial financial burden for these patients.