Managed Care


Step therapy comeback continues

MANAGED CARE September 2012. © MediMedia USA
Managed Care Outlook

Step therapy comeback continues

Large employers plan to turn to classic managed care techniques to cut pharmacy costs in 2013, according to a study by the National Business Group on Health. Companies expect benefit costs to rise an average of 7 percent, says NBGH, which represents 342 large employers.

“As employers have become more and more challenged by the costs of health benefits in the worst economy in decades, they have returned to some of the older methods of cost and utilization controls, previously used in the managed care era,” says Helen Darling, the NBGH’s president and CEO.

Step therapy, in particular, has become “an increasingly important way for employers to ensure that patients try the most appropriate and usually least costly drug before they try the often newer and most expensive prescription drugs. As prescription drugs have become more expensive, especially specialty drugs, and as many more people are using them, employers have looked for ways to moderate that trend.”

Eighty-two companies, representing about 4.2 million workers, responded to the survey. It was conducted between June 10 and July 6, and released in August.

Which plan techniques will you use in 2013 to manage your pharmacy benefit?

For 2013, which methods will you use to manage specialty pharmaceuticals?

Source: National Business Group on Health, “Large Employers’ 2013 Health Plan Design Survey,” August 2012


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