Author Affiliation: Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.
Health care costs are increasing rapidly again. A recent employer survey
reported that health insurance premiums increased 12.7% from 2001 to 2002,
the largest increase since 1990.1 The fastest
rising component of health care costs is pharmaceuticals. From 1999 to 2000,
national expenditures for prescription drugs increased 17.3% overall, and
19.6% for private insurance.2 Since the late
1990s, when prescription costs began rising more rapidly than other health
care costs, employers have been working with their insurers and pharmacy benefit
managers to develop prescription drug coverage plans that would better control
costs. Many employers now offer 2- or 3-tier prescription drug coverage plans,
with the amount of out-of-pocket cost increasing from bottom to top tiers.
Although plans vary, the lowest tier usually includes the low-cost generic
drugs, the second tier may include brand-name drugs for which no generic exists,
and the third tier brand-name drugs for which generic substitutes do exist.
Steinwachs DM. Pharmacy Benefit Plans and Prescription Drug Spending. JAMA. 2002;288(14):1773-1774. doi:10.1001/jama.288.14.1773