Researcher first to study and report on prescription drug benefit tool
ST. LOUIS, June 28, 2000 -- Researcher Brenda Motheral, PhD, told participants of the fourth annual Express Scripts (NASD: ESRX) Outcomes Conference, held in St. Louis, that recent data indicates three-tier co-pay prescription programs have enjoyed a great deal of success since their inception two years ago.
Motheral, the author of numerous articles in the area of outcomes research, claims database methodology and managed care, conducted the first study within the healthcare industry that documents how implementation of a three-tier prescription co-pay plan affects pharmaceutical and medical utilization and expenditures, continuation with chronic medications and the percent of enrollees affected.
She told conference participants that the relatively new co-pay structure can significantly lower payers' trend in pharmaceutical expenditures, and members are not showing evidence of medication noncompliance, as was expected by some industry experts when the three-tier medication co-pay structure was initiated three years ago.
Motheral and co-investigator, Kathi Fairman, studied two comparable preferred provider organization (PPO) groups located in the same state. The plans had nearly identical demographic profiles in terms of age, gender and incidence of chronic illness.
Group one instituted a three-tier co-pay plan in 1998, changing from a two-tier plan with a $7/$12 co-pay structure to a co-pay structure of $8/$15/$25, depending on the tier level. For the year preceding implementation, drugs that were placed on tier three (brand name/non-formulary) constituted 14 percent of prescription claims.
Group two, the control group, maintained its $7/$12 two-tier structure for the duration of the study.
The study substantiated the claim that a three-tier structure can significantly lower plan sponsors' trend in pharmaceu
Contact: Ryan Soderstrom
Kupper Parker Communications