Pharmacy Cost Management: How to Make Pharmacy Discount Cards Work for You and Your Employees

Pharmacy Cost Management: How to Make Pharmacy Discount Cards Work for You and Your Employees

0

Pharmacy discount cards are prolific. You’ll find them in doctor’s offices, pharmacies and all over the internet. They promise deep discounts on common, generic maintenance medications and more. Employees in high-deductible plans and people without insurance may especially find the cards enticing. How should you advise your employees about using them? Should you even consider promoting them or offering your own, branded cards?

 

Advantages of publicly available cards
  • The cards can offer steep discounts. While savings vary greatly – even from day to day – your employees could see discounts as high as 75%.
  • When your employees skip using your plan in favor of the cards, their expenses don’t apply to the plan. That means lower claims costs for you.
  • The programs can be a helpful tool in the toolbox you offer employees to help manage their costs in a high-deductible plan.

 

Advantages of employer-provided cards
    • You can even offer a discount card directly to your employees. A branded card offers additional value.
  • You’re able to deliver a meaningful benefit to part-time or seasonal employees who aren’t eligible for your medical coverage.
  • You may offer it as an alternative for certain therapeutic classes or specialty drugs your plan doesn’t cover, such as lifestyle medications, growth hormones or fertility drugs.
  • With control over the card, you’re able to track utilization for future planning purposes.
  • The card is portable. The employee can continue using it if they leave your company.

 

Cautions
  • When employees use the cards, their expenditures don’t get applied to their deductible. For those who never get close to the deductible, that’s not a problem. But employees who get near or reach the deductible may regret having used them. This is a tough one to explain! (Note: Some PBMs will work with you to process paper claims for these expenditures and give employees credit for what they would have paid under the plan. You’ll pay a few dollars for processing, but this allows both you and the employee to benefit.)
  • You will miss out on any rebates for drugs purchased outside your plan.
  • Employees won’t have the benefit of the PBM monitoring all their medications and flagging potential interactions.
  • Using the cards successfully requires some effort. The employee needs to check the price under the plan vs. the card, which can be difficult. In addition, the programs’ pricing changes from one day to the next. And, getting the best price may require the employee to move their prescription from one pharmacy to another for each refill. This can generate a lot of calls to HR!
  • The benefit of the cards to those on Medicare is less clear. This is another important factor to consider in communicating about the cards.

The pressure of pharmacy costs doesn’t show signs of abating any time soon. Investigating the value of pharmacy discount cards is a small step you can take to relieve that pressure for both you and your employees.

 

By Tracy Johnson, Director of Pharmacy Benefits, Employee Benefits

See Also:

Pharmacy Cost Management: Can You Benefit From Recent FDA Guidance On Biosimilar Replacements?

Pharmacy Cost Management: 5 Tips for Managing Your Pharmacy Benefits Partner

The High Price of Drugs: 4 Ways to Manage Your Pharmacy Cost

Leave a Reply

Your email address will not be published. Required fields are marked *