The new “consumer-driven health plans” may be falling behind traditional pharmacy benefit managers in the area of high-tech support services.
Researchers at Pharmaceutical Strategies Group L.P., Dallas, have published data supporting that assessment in a summary of an informal survey of 49 benefit plan sponsors.
About 56% of the participating plans now offer health plans that incorporate health savings accounts or health reimbursement arrangements or hope to offer account-based plans in the next 12 months.
At this point, only about 6% of the employees eligible for the participants’ existing account-based plans have signed up for those plans, survey participants reported.
The health account programs seem to be holding down increases in drug costs, but the decrease has been less than the participating employers had hoped, according to PSG researchers.
One reason may be that employers reported that the account-based plans were less likely to use the tiered formularies and other mechanisms that conventional PBMs use to hold down pharmacy costs.
But the PSG researchers found that another reason may be that the account-based plan vendors tend to offer fewer Web-based decision support tools than the conventional PBMs offer.
Only 14% of the account-based plan sponsors reported, for example, that they get real-time drug pricing from the account-based plan vendors, and only 14% of those sponsors said the account-based plan vendors tracked prescriptions to see whether patients might be facing potentially dangerous drug interactions.
Meanwhile, 43% of the sponsors of account-based plans said their conventional PBMs provided real-time drug pricing information, and 57% said their conventional PBMs monitored plan members for potentially dangerous drug interactions.