Are more prescription drugs better or worse? And how many are too many or too few? These are difficult questions for most health plan sponsors to answer. One thing is clear: there is significant variation between the usage levels from one group to another.
According to our last Deep Dive Benchmark Data Survey, each member obtains an average of 10 scripts per year. The 75th percentile is 12 scripts per member per year, with the 25th percentile coming in at 8. The highest plan’s count was 16 scripts per member per year and the low was 3.
As you might expect, there is a solid correlation between higher average age and higher script counts. Interestingly, high script counts have more correlation with high medical benefit costs than with high prescription drug benefit costs.
Maybe even more significant is that script counts have no correlation to HDHP enrollment levels, and there is more script count variation within industry groups than between industry groups.
Of course, there is a lot more to managing the value of your prescription drug spend than counting scripts. Let us know if you would like one of our experts to help you reduce unnecessary spend and waste within your drug or your medical benefit programs.
*From Chelko Consulting Group’s proprietary database of employer results.
“Keeping Score” is an ongoing series where we share findings from our work on employer-sponsored health plans, so you have the opportunity to compare how your plan is performing relative to others. We hope you find it beneficial. Because, after all, you can’t manage what you don’t measure.