Survey: employers to encourage generic medications

CVS Caremark has announced the results of its annual employer client benefit survey about priorities for pharmacy benefit management (PBM) services in the coming year. The majority of employers surveyed (94%) said they will seek opportunities to improve savings even more in 2010, while they look for ways to improve the overall member experience. Employers listed price (86%), customer service (86%), trust and reliability (84%) and consumer engagement capabilities (46%) as key priorities for their PBM procurement strategy.

The economic environment continues to impact companies, with 66% of respondents answering that reducing overall healthcare costs is their No. 1 success measure, says Jack Bruner, executive vice president, Strategic Development, CVS Caremark Pharmacy Services.

Survey results show that the majority of employer clients are strongly considering adopting some of the more progressive strategies to encourage the use of lower-cost generic medications. For example, almost half of employers surveyed are considering implementing plan designs that require using a generic medication first before moving to a branded drug (50%) and those that provide members a co-pay waiver to switch to generic medications (56%).

“For our book of business, approximately 35% of brand-spend medications have a generic opportunity,” says Bruner. “Our strategy is to focus on specific therapeutic classes (e.g., proton pump inhibitors, HMG reductase inhibitors, angiotensin II receptor blockers, hypnotic sleep aids, migraine agents, nasal steroids, non-sedating antihistamines, selective serotonin reuptake inhibitors, etc.) where ample generics are available.

According to the survey, a majority of employer clients (88%) and health plan clients (97%) are taking an aggressive or moderate approach toward maximizing generic dispensing in key therapeutic classes as a strategy to increase savings opportunities.

Through 2012, nearly 30 brand-name medications in a variety of classes are expected to become available as generics, including some popular drugs such as Lipitor for treating high cholesterol, according to Bruner.

“We anticipate this will have an impact on opportunities for increasing generic dispensing rate for our clients, resulting in increases savings for clients and their members,” he says.

Bruner expects the rate of employees actually taking advantage of generic substitution/lower-cost alternatives to vary depending on the type of intervention program that is implemented.

“For example, if a client adopts a mandatory generic use program such as step therapy, we see greater than 80% brand to generic substitution/conversion within a therapeutic class,” he says. “If the client implements a generic co-pay waiver to incent brand users to switch to generics, the behavior change rate is less than 10%. However, when a pharmacist counsels a patient at retail or mail about a generic opportunity, the conversion rate is over 30%.”

Compared to the 2009 survey results, the survey found there has been an increase in employers who are adopting or considering solutions to improve medication adherence. In particular, many employer clients are considering programs that impact adherence through counseling and intervention with the member, including: counseling to improve adherence the first time a member fills a maintenance medication (62%), outreach to prescribers to resolve gaps in care (56%) and outreach to members and prescribers to provide counsel about therapy drop-off (65%).

The CVS Caremark client survey was conducted online from Oct. 5, 2009 through Dec. 31, 2009 and includes responses from current CVS Caremark clients representing 285 employers.