This article is from the Daily Labor Report
Issue No. 124 - June 28, 2008 ISSN 1522-5968
Employers' efforts to shift the costs of health care, including pharmacy benefits, to their employees actually do not save employers money and are discouraging treatment essential to worker productivity, according to a report released June 27 by the Integrated Benefits Institute (IBI).
San Francisco-based IBI said health care costs are rising "much faster than the rate of inflation, causing employers to use strategies to control costs for pharmaceuticals including higher copays, tiered benefit plans and higher deductibles."
IBI's study focused on the increased disability and absence-related lost productivity that result when employers raise employee out-of-pocket expenses for prescription medicine for rheumatoid arthritis. IBI said the researchers analyzed rheumatoid arthritis "because there are clear evidence-based medical guidelines regarding prescribed medications and a strong connection between rheumatoid arthritis and work disability." Workers with rheumatoid arthritis often have three times the medical costs, two times the hospitalization rate, and 10 times the work-disability rate of a similar population, IBI said.
IBI is supported by employers, consultants, insurers, health care providers, disease management firms, third-party administrators, pharmaceutical companies, and behavioral health providers.
The nonprofit organization said its research examined how pharmacy benefit design influences "drug adherence" by patients or whether patients fill and maintain their prescriptions. The study then analyzed the impact of drug adherence on nonoccupational disability and productivity loss. The study used data provided by health information technology company Ingenix for more than 1 million people and 17 employers from across the United States, including 5,483 employees with rheumatoid arthritis.
IBI's report, A Broader Reach for Pharmacy Plan Design, looked at two types of rheumatoid arthritis drugs: symptom-relieving drugs (e.g., anti-inflammatories and analgesics), and drugs that delay progression of the disease itself (disease-modifying anti-rheumatic agents, or DMARDs).
The report said higher out-of-pocket expenses for employees reduced medication adherence, with less than two-thirds of diagnosed individuals filling at least one symptom relieving prescription and only 45 percent filling at least one DMARD.
The report also found that the employers with a higher number of employees filling at least one DMARD prescription have fewer short-term disability incidents.
In terms of productivity, the organization found higher short-term disability incidence and longer duration resulting in greater costs and lower productivity for companies. IBI modeled the lost productivity differences if those who filled no prescriptions had filled as many as those who had filled at least one. "Compared to a baseline of $17 million in lost productivity, the savings difference amounts to $3.2 million from reduced incidence and an additional $1.2 million from shorter durations," the group said.
"It is unfortunate tat employees appear to make medical decisions based on price and cost shifting, rather than evidence-based medicine," IBI President Thomas Parry said. "Unfortunately, increasing copays for workers can often make a bad situation worse."
