By Bill Olson
Chief Marketing Officer at United Benefit Advisors
Most 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%)
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.