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Nearly Half of Americans Have Experienced Challenges Obtaining

Nearly Half of Americans Have Experienced Challenges Obtaining

What You Should Know:

– RxBenefits, the employee benefits industry’s first and only technology-enabled pharmacy benefits optimizer (PBO), announced the results of a new study which reveals that 73% of Americans are currently covered by their employers health benefits plan with prescription drug coverage, with 80% stating it is very or somewhat important that their current or future employer cover the cost of their — or their family members — specialty medications.

– The survey was conducted online within the United States by The Harris Poll on behalf of RxBenefits between June 24-28, 2021, among 2,013 adults ages 18+.

Rising Costs of Specialty Medications

The use and costs of specialty medications are increasing year over year, with prescription drug spend expected to grow by over $110 billion by 2024. Considering specialty medications now account for as much as 50% of a hospital’s pharmacy benefit costs, who is expected to bear the burden of such high costs? For hospitals and health systems, it’s just as critical for these systems to select a pharmacy benefits partner that can meet the organization’s needs as both an employer and a healthcare provider.

Additional findings of the survey include:

– Of the 49% of Americans who have experienced challenges or roadblocks obtaining their specialty medications, the top challenge experienced was the overall cost of the medication being too high (24%), followed by 16% stating the medication not being covered by an employer-provided health plan

– Americans ages 18-44 were more likely than those ages 45+ to say they would change jobs to get coverage if their employer-provided benefits did not cover the cost of their — or a family member’s — specialty medications (19% vs. 5%)

– Americans ages 18-44 are more likely than those ages 55+ to say they would involve their company’s HR department to gain coverage (21% vs. 10%)

“Specialty drug utilization continues to increase, and is showing no signs of slowing down. In fact, specialty medication costs accounted for over 50% of the total pharmacy spend incurred in 2020. While specialty carve-out has often been touted as an effective method to contain costs, the approach is not effective for employers and can actually cause severe member and service disruption,” said Bryan Statham, Chief Executive Officer, RxBenefits. “In today’s market where talent acquisition is highly competitive, it’s clear that employers must go beyond simply providing a paycheck to attract and retain talent. Providing a rich benefits package while keeping costs in check is one way to achieve this, which ultimately results in a healthier bottom line and a happier workforce. However, it needn’t come at a huge expense to self-funded employers.”

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