Health Plan Design Solutions
GENERICS & BIOSIMILARS
Medicare Part D information is publicly available whereas commercial plan data is not easily accessed to track these points; however, the same PBMs are driving commercial plans today. It is highly unlikely that PBMs would behave differently on commercial plans without active management by employers to protect their bottom line.
Denying patients access to lower-cost generics and biosimilars increases patient cost during their deductible period, lowers patient adherence to drug therapy on more expensive medicines, and raises costs for employer-based health plans.
We strongly urge employers to investigate this practice in their plans and ensure their plan participants have access to lower-cost medications.
More details can be found in this article by DLC’s CEO George Huntley on BenefitsPro.com.