By Bill Olson
Chief Mar­ket­ing Offi­cer at Unit­ed Ben­e­fit Advisors

RxPhotoMost employ­ers have been using mul­ti-tier pre­scrip­tion drug plans for many years, but new data released from the 2014 UBA Health Plan Sur­vey shows a sig­nif­i­cant increase in the use of 4‑tier plans, which typ­i­cal­ly cov­er the high­est cost drugs, as well as major increas­es in cor­re­spond­ing medi­an copays – a trend that is expect­ed to continue.

UBA’s sur­vey finds that, since 2009, the num­ber of 4‑tier plans has grown from 13.6 per­cent to 32.9 per­cent of all plans offered, a 141.9 per­cent increase. Since 2012, tier 4 medi­an copays have also grown 25 per­cent; in 2014, 4‑tier plans had medi­an copays of $10, $35, $55 and $100.

Accord­ing to UBA’s sur­vey, 57.1 per­cent of all pre­scrip­tion drug plans uti­lize three tiers (gener­ic, for­mu­la­ry brand, and non-for­mu­la­ry brand), 6.8 per­cent retain a 2‑tier plan, and 32.9 per­cent offer four tiers or more. In five years (since 2009), the num­ber of 3‑tier plans has decreased 20.4 per­cent (from 71.7 per­cent to 57.1 per­cent) and 2‑tier plans have decreased 45.6 per­cent (from 12.5 per­cent to 6.8 per­cent) in that same time period.

  • Employ­er size with the most 3‑tier plans: employ­ers with 500 to 999 employ­ees (70%)
  • Employ­er size with the least 3‑tier plans: employ­ers with few­er than 10 employ­ees (48.2%)
  • Employ­er size with the most 4‑tier plans: employ­ers with 10 to 24 employ­ees (40%)
  • Employ­er size with the least 4‑tier plans: employ­ers with 500 to 999 employ­ees (20%)

RxDrugTiers

Read UBA’s full press release includ­ing the lat­est com­men­tary from UBA Part­ners on these trends.

Get the most up-to-date trends in phar­ma­cy copay design.

Down­load the UBA Health Plan Sur­vey Exec­u­tive Sum­ma­ry with com­plete find­ings on plan design and costs by region, indus­try and employ­er size.

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