Managed care organizations often place costly new drugs on a formulary's priciest tier, but products for which substitutes do not exist often are made available at lower copayment levels. Average copayments for single-source, brand-name products are considerably lower than those for branded compounds available from multiple sources. Interpretation suggests that employers and MCOs recognize that access to products for which substitutes are unavailable — particularly when they can save lives or reduce morbidity — is important, even though the relative cost of most single-source products is high.
Average copayments, by product source, 1999
SOURCE: WYETH-AYERST PRESCRIPTION DRUG BENEFIT COST AND PLAN DESIGN SURVEY, COPYRIGHT 2000, PHARMACY BENEFIT MANAGEMENT INSTITUTE, TEMPE, ARIZ.