Magazine article Drug Topics

Three Cheers for Three Tiers

Magazine article Drug Topics

Three Cheers for Three Tiers

Article excerpt

Not long ago, three-tier pharmacy benefits were The Next Big Thing in managed care. Some of the companies that caught that wave are now reporting positive early results, though it's too early to tell how valuable variable co-pays will be as a costreduction measure.

According to Eric Bergen, v.p.ancillary care services for UnitedHealth Group in Edina, Minn., the decision to go to a three-tier pharmacy benefit was made simpler by the fact that his company's offerings did not reflect customers' needs. "Customers wanted choice, but they also wanted cost control," he said, in a presentation at the Academy of Managed Care Pharmacy (AMCP) Educational Conference in Atlanta last month.

However, plan members are expected to pay more for having additional options. UnitedHealth Group members with pharmacy coverage pay $7 for generics; between $12 and $15 for preferred drugs, depending on the customer; and $25-$35 for nonpreferred branded drugs. Those copays reflect increases from the company's previous levels of $5, $10, and $25, respectively. …

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