With the start of a new fiscal year around the corner, UCHealth has some welcome news for employees: sharply lower prices for some brand-name drugs.
The savings are for all UCHealth employees – Metro Denver, Northern Colorado and Colorado Springs – and their dependents who are enrolled in a CU Health Plan. They apply to 13 brand-name drugs the plan classifies as “tier 2,” or preferred, said Matt Ellis, PharmD, a clinical pharmacist with UCHealth Metro Denver (University of Colorado Hospital) who works on the CU Health Plan Medication Management team.
In his research to find prescription savings for employees, Ellis discovered that manufacturers offer copay assistance cards for many brand-name drugs. He then searched pharmacy records to determine how many UCHealth employees were taking the drugs he identified. He found more than 500 at Metro Denver and more than 800 for the entire UCHealth system – and concluded that they didn’t know about the cards.
“I found that there were many medications that employees were getting filled with brand-name drugs and paying the full copay,” Ellis said.
Cut to the chase
The cards, easily available on the internet, offer huge savings, Ellis said. For example, nearly 200 UCHealth employees covered by a CU Health Plan have prescriptions for Advair, a medication that treats asthma and COPD (see box). In fiscal year 2017 (starting July 1), their standard copay will be $40 for a 30-day supply and $80 for a 90-day supply. But with a copay card, the cost for Advair drops to $10 for a 30-day refill or $30 for 90 days. That’s good for 12 uses in a year, Ellis said. The bottom line: a maximum annual savings of $360.
The cost reductions alone make the copay card program a good way for UCHealth to engage staff, and the Human Resources team plans to let new hires know about it when they join the organization. But Andrew Davis, PharmD, associate director of Ambulatory Care Pharmacy Services at Metro Denver, said there are also important potential health benefits.
“This program removes the cost barrier to employees picking up their meds,” Davis said. “We hope they will then pick up their prescriptions when they are due for refills rather than having to wait until payday.”
Bringing down barriers, bringing up health
Ellis noted that medical and pharmacy literature suggest that the better patients adhere to their medication regimens, the less likely they are to require additional medical care, including hospitalizations and emergency visits. That is important to maintaining the health and quality of life of plan enrollees. Medication adherence also helps to control the overall cost of health care – a key consideration because the CU Health Plan is self-funded. That is, as employers of the CU Health and Welfare Trust, UCHealth, the University of Colorado, and University Physicians, Inc. are each responsible for providing health care benefits for their employees and paying for their claims as they occur.
Lower-cost prescriptions, it is hoped, will encourage employees to refill their prescriptions regularly and stay healthier. That, in turn, could help to manage health care costs and premium rates.
Davis said that in the future he envisions a broader effort in which Pharmacy works with medical providers to help employees find ways to manage their conditions more effectively, better understand their prescriptions, improve and maintain their overall health, and save money.
Meanwhile, the Pharmacy team plans to notify employees and their dependents of the copay program through My Health Connection and an email or letter that lists the covered drugs and the websites they can use to check their eligibility and print cards.
Davis said that after this “active outreach” phase, Pharmacy plans to train staff to question any prescription copay that is higher than $30.
“We will provide staff with the information and resources to have all eligible patients apply for these manufacturer copay cards,” Davis said.
For questions and additional information, email [email protected] or leave a voicemail at 720-848-3377.
A savings sampler
Three examples of brand-name drugs that offer manufacturer copay assistance cards. UCHealth employees enrolled in a CU Health Plan will be able to use cards to decrease copay costs for these and 10 other brand-name drugs starting July 1.
|Drug||Copay (as of July 1)||Copay with card||Maximum annual savings*|
|Advair (asthma)||$40 for 30 days; $80 for 90 days||$10 for 30 days; good for 12 uses||$360|
|Xarelto (anticoagulant)||$40 for 30 days; $80 for 90 days||$0||$480|
|Focalin XR (ADHD)||$50 for 30 days; $100 for 90 days||$0 for 30 days; $20 for 90 days||$600|
*For those enrolled in Exclusive2 plan.