Prescription Cost Management – A Critical and Complex Issue
The cost of prescription medications has been a major news story lately, with a focus on cases of allegedly egregious pricing practices. But those are just the headlines leading a story that hits all players in the health care market.
To gain insight on potential ways to address this challenge, we recently did a survey with MCOL, a leading publisher of health care business information, asking health care business stakeholders about the management of these costs.
Here are highlights of the results:
- 97% of respondents felt the issue is “difficult and challenging.”
- 87% felt new/additional resources for managing these costs should receive higher priority than for managing other health care cost components.
- Pharmaceutical companies have the greatest potential control over these costs, followed by pharmacy benefit management systems and health plans.
- Specialty drug utilization and pharmaceutical drug pricing policies are the top two contributors to cost increases.
- Government regulation, formulary management and drug utilization review, and value-based insurance design are the top three solutions.
The survey universe represented a cross-section of stakeholders in this issue that included employers, unions and employer coalitions; health plans, third-party administrators and exchanges; health care providers; vendors; and others affiliated with the field.
That’s an impressive array of organizations (not to mention health care consumer themselves) that are impacted by this fundamental challenge. Solving it will require innovation and ideas from all sides.