WELLESLEY, Mass., Sept. 24, 2020 /PRNewswire/ -- As employees make 2020-2021 healthcare elections, pharmacy benefits decision makers reveal the method behind their plans in new survey data released today by Scripta Insights, a cloud-based healthcare IT solution that helps companies take control of their pharmacy benefit spend, while helping members get the Best Meds at the Right Price™. Scripta surveyed 77 human resources professionals at self-insured companies in August 2020 and results show employers and members could be saving a lot more.
"The prescription drug market changes daily--and so do employee populations. To control costs, employers should constantly be reevaluating their plan design, yet our survey found that most are only making changes every two to five years," said Eric Levin, CEO at Scripta Insights. "Technologies like Scripta can help employers gain unprecedented insights into their spending every single month, driving high-impact monthly adjustments and providing unbiased analysis of PBM bills. This technology enabled discipline creates enormous opportunities to save, both for employers and members."
Levin added, "We were surprised to learn that most companies are not making changes because of COVID-19 this year. Between the overall increase in prescription fills and heightened demand for certain medications, employers would be wise to evaluate any changes since March and how they are affecting overall cost."
Key Takeaways: Making the Tough Decisions on Pharmacy Benefits
In a market that changes daily, employers need to reevaluate more often
- Only 12% of respondents change their pharmacy plan design every year, with most (57%) indicating that they make changes only every 2 to as much as 5 years.
- 17% of respondents change their plan once a decade or never.
- Only 39% of respondents deemed "length of contract" as an important factor they consider before signing a PBM contract.
Scripta Insight: With a prescription drug market that changes almost daily, it's critical that companies reevaluate their plan design as often as possible. In fact, Scripta finds that most contracts are out-of-alignment with market realities just 90 days after implementation. When signing a PBM contract, it's important not to be locked into a multi-year deal. However, if a company does a longer term deal, it is imperative that the contract include a "market check" clause that allows annual adjustments. Three years from now, the prescription drug market will look vastly different and your pharmacy benefits plan should, too.
Pharmacy benefits decision-makers think they have the tools they need… but do they?
- 79% of respondents feel they have the tools they need to properly evaluate their PBM bill.
- However, 65% of respondents do not get regular analysis of their bill from an entity other than their benefits consultant or PBM.
- Only 27% of respondents receive analysis of their PBM bill every month.
- 21% of respondents are unsure if their benefits consultant firm has a pharmacy practice specialist or they can never get in touch with them.
Scripta Insight: Employers should have objective, independent analysis done every month, giving them a clear picture of their current spending and market changes. Getting an analysis from a third-party entity gives you an unbiased opinion about where you could be saving. Getting your analytics directly from your PBM vendor is letting the fox guard the hen house.
Employers are systemically accepting price increases during the budgeting process...therefore giving ground to PBMs before the negotiation even begins
- The majority (88%) of respondents said their company systematically budgets up to 10% for pharmacy benefits cost increases annually (by simply carrying forward past increase trends at the beginning of the budgeting process).
- 52% of respondents at companies that spend $5 million or more on pharmacy benefits each year budget 6-10% for increases annually -- that's a possible increase of more than half a million dollars per year!
- 40% of respondents said it would take an increase of 11-20% to make them reevaluate their pharmacy benefits plan.
- All this is despite the fact that 88% of respondents say lowering pharmacy benefits spend is somewhat or very important to their executive leadership and/or CFO.
Scripta Insight: There are no valid reasons for companies to accept astronomical increases year-over-year. Smart analysis of your own data on a regular basis can lead to enormous savings opportunities that keep budgets in check--and can better align HR leadership with CEO/CFO leadership and company priorities.
Employer offerings don't always match employee priorities
- 92% of respondents said that lowering out-of-pocket costs on prescriptions is somewhat or very important to their employees.
- However, only 31% of employers offer a prescription savings program or coupon service.
Scripta Insight: Employees are more likely to comply with medications prescribed by their doctor, and stay healthier, if they can afford the medication. When employees save on prescriptions, self-insured employers save as well, making these programs and services a smart perk to offer that will be welcomed by employees as a positive new benefit.
Smaller companies with fewer resources may be missing out on opportunities to save
- Companies with 5,001+ employees are 33% more likely to speak regularly with the pharmacy practice specialist at their benefits consultant firm than smaller companies.
- Just 25% of companies with 5,000 or less employees offer a prescription savings program or coupon service to employees vs. 44% of companies with 5,001+ employees.
- Companies with 5,001+ employees are 11% more likely to look at their own data when making decisions about their pharmacy benefit plan design than smaller companies.
Scripta Insight: It's no surprise that bigger companies benefit from more resources, but that doesn't mean that smaller companies can't find ways to save. Finding a few dollars in savings for a few thousand lives adds up. Your company and your employees will benefit, so it's a win-win! New breakthrough technologies like Scripta can help mid-market companies get the same level of service (if not better) that jumbo employers get when it comes to pharmacy benefit cost containment.
As COVID-19 changes the world, it's not changing pharmacy benefits plans
- 92% of respondents are not making changes to their pharmacy plan design this year because of COVID-19.
- Of the respondents, 100% who work for companies with more than 1,001 employees are not making changes.
- Only 22% of respondents who work for companies with 1,000 or less employees will make changes, which include switching PBMs, covering COVID-19 testing at 100% and adjusting copay tiers.
Scripta Insight: The world has changed drastically this year, and so has the way that consumers fill their prescriptions. Since the beginning of the pandemic, there have been increases in the number of fills at the pharmacy and increased demand for certain medications. With no real end in sight until at least next year, employers would be smart to evaluate their plans to ensure that they aren't spending too much.
For more from Scripta's survey, visit: https://www.scriptainsights.com/self-insured-employers-rx-benefits
About Scripta Insights
Scripta Insights, a company founded by doctors, is using technology to create transparency, disrupt and improve the $300B self-funded pharmacy benefits marketplace.
Scripta is a healthcare IT solution that delivers immediate, real savings on pharmacy benefit costs for self-insured employers, payers and their members. It empowers companies to take control of their pharmacy spend, while helping members get the medicine they need at the best possible price.
Scripta's proprietary software, Script.AI, was developed over a decade and is designed to analyze millions of pharmacy transactions in mere seconds to yield actionable insights. It uses data analytics, AI and expert insights from its P&T Committee to recognize savings opportunities that, until now, have been impossible to identify.
Scripta has saved employers and members millions of dollars on prescriptions.
For more information about Scripta, visit www.scriptainsights.com.
Contact: Stephanie Ciosek, LKPR Inc., [email protected], 914-806-5767
SOURCE Scripta Insights