Depression-treating drugs lead record-setting pharmacy benefit cost rise -- Total increase lower when pharmacy benefit actively managed

ST. LOUIS, June 29, 1999 -- America's growing use of depression-treating drugs like Prozac, Zoloft and Paxil made antidepressants the biggest contributors to a record-setting pharmacy benefit cost increase of 16.8 percent last year, according to a study by the country's largest independent pharmacy benefit manager, Express Scripts, Inc.

Not everyone was hit by the full cost increase. "Plan sponsors that successfully navigated the challenging pharmacy landscape were able to cut the cost increase in half by actively managing their pharmacy benefit to encourage the use of lower cost but equally effective and safe drugs," said Barrett Toan, chief executive officer of Express Scripts.

For consumers, the cost increases mean they will pay a bigger share of the expense in the form of higher copayments ranging from $5 for generic drugs to $25 or more for selected, single source brands. Employers and other pharmacy benefit plan sponsors currently pay as much as 80 percent of a prescription's cost which can amount to more than a hundred dollars each in some cases.

Plan sponsors used carefully constructed formularies, three tier copayments and other approaches to control costs and maintain access to pharmacy benefits despite the discovery of more innovative drugs, faster FDA approvals and more widespread direct-to-consumer marketing, according to Toan.

Last year's annual per member cost -- on an average wholesale price (AWP) basis before copayments, discounts and active management -- was $329.48 up from $282.48 in 1997. New drugs introduced since 1992 accounted for 35.6 percent or $117.55 of the 1998 pharmacy benefit cost. A single prescription for a post-1992 new drug cost an average of $72 in 1998.

The unmanaged AWP cost increase was the largest reported by Express Scripts since 1993, when the company began monitoring drug cost and utilization trends among its members, which now number 47 million. Another increase of more than 16 percent is

Contact: Steve Littlejohn
Kupper Parker Communications

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