Tom's Take Blog

March 20, 2019

How do issues of medication management factor into prescription costs with health plans?

Tom’s Take: Ask just about any employer who offers a health plan, and a common frustration is the growing cost of prescription drugs. Reducing this expense is far from a simple fix, though. It requires a multi-prong approach, and educating members about medication management is one essential aspect of it.

 

With the number of chronic conditions and comorbidities on the rise, patients are taking more prescription drugs. If these medications aren’t properly managed, it can affect people’s health – and further escalate costs at the same time. This is why a lot of health plans have pharmacy benefit managers (PBMs) and other engagement programs in place to focus on the importance of proper medication management.

 

Here are a few common issues that come up with prescriptions:

 

  • Noncompliance in taking medications due to out-of-pocket cost constraints
  • Failure to take drugs as prescribed according to instructed dosage and timing
  • Prescriptions from multiple providers without coordinated consultation on what can and cannot be taken together
  • Limited knowledge on generics that are available in place of high-cost brand-name drugs

 

While issues like these can drive up avoidable care and plan expenses in many cases, some can also lead to serious health concerns, with the potential to land members in the ER or hospital. Using a PBM and supplementing your employee benefits with other proactive medication management programs can make a big, positive difference in terms of plan costs and overall patient well-being.

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