Trends in Drug Benefit Design Report Released by Pharmaceutical Strategies Group

Results in PSG’s latest benefit design research reveal an increased focus on member satisfaction

New research on the latest trends in benefit design launches today. Pharmaceutical Strategies Group (PSG), an EPIC company, developed the Trends in Drug Benefit Design Report—sponsored by Rx Savings Solutions. The proprietary research uncovers salient insights into the perceptions and challenges around high deductible health plans (HDHPs), the role of member experience, formulary strategy, and how the Great Resignation and pandemic have shifted plan design priorities.

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“Plan sponsors must constantly review trends and adjust plan design and programs to meet current needs and marketplace conditions,” said Michael Lonergan, RPh, President of PSG. “This research puts a microscope on benefit design, offering insight into how to be proactive and innovative to create affordable and accessible pharmacy benefits.”

Member acceptance is a barrier to utilization management (UM) programs

A third of respondents cited reducing inappropriate utilization as their top goal outside of managing trend, but more than half (57%) of respondents consider lack of member acceptance a barrier to trend and UM programs.

The top challenge with formulary exclusions is member dissatisfaction

“The majority of respondents (69%) cite member dissatisfaction as their top challenge with formulary exclusions,” said Morgan Lee, Senior Director of Research and Strategy at PSG. “Yet 81% of respondents use formulary exclusions.”

Plan design priorities shifting to accommodate current market dynamics: The Great Resignation, COVID-19

The report shows nearly half of respondents (41%) increased their focus on member experience since the start of the pandemic.

“Plan designs evolve, solutions come and go, and priorities shift. At the end of the day, consumers shoulder an increasingly unsustainable share of medical and pharmacy costs,” said Michael Rea, PharmD, Founder and CEO of Rx Savings Solutions (RxSS). “The research conducted by PSG will help inform drug benefit design decisions that work toward an elusive but important goal, one that is underscored by the impact of COVID-19 and the Great Resignation.”

Key takeaways from the Trends in Drug Benefit Design Report include:

• 35% of respondents agree or strongly agree that HDHPs manage overall drug trend; 51% agree or strongly agree that HDHPs help members
• 57% of respondents cite member acceptance as a barrier to trend and UM programs; 33% say reducing inappropriate utilization is their top goal outside of managing trend
• 69% of respondents cite member dissatisfaction as their top challenge with formulary exclusions; 81% use formulary exclusions
• 41% of respondents say the importance of member experience has increased somewhat or greatly since the start of the pandemic; 27% report the Great Resignation has impacted their benefit strategy

Download the Trends in Drug Benefit Design Report: https://rxss.com/benefit-design-report/

About the 2022 Trends in Drug Benefit Design Report

PSG has been a leader in drug benefit design research for over 25 years. The Trends in Drug Benefit Design Report provides in-depth insights into traditional (non-specialty) drug benefit trends and strategies. The survey sample informing this report included 153 benefits leaders representing plan sponsors of an estimated 35.1 million covered lives. This report focuses on drug benefit design for the 2022 benefit year among employers, union/Taft-Hartley, and health plan respondents.

About Pharmaceutical Strategies Group

Pharmaceutical Strategies Group, an EPIC company, relentlessly advocates for clients as they navigate complex and ever-changing drug cost management challenges. PSG functions as a strategic partner through industry-leading intelligence and technologies to realize billions of dollars in drug cost savings for clients every year.

About Rx Savings Solutions – Report Sponsor

Founded by a pharmacist, Rx Savings Solutions helps people and payers reduce prescription drug costs through a combination of clinical technology, transparency, member engagement and concierge support. Currently 17 million members have access to personalized recommendations for lowering prescription costs and dedicated pharmacy experts to help navigate benefits, providers and pharmacies. For more information, visit rxss.com or follow them on LinkedIn and Twitter.

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