No Pharmacy Coverage – I Doubt It

In the AIS e-mail on Friday, it had the following quote:

“If the economy remains weak over the long term, we could certainly see employers and government agencies looking to investigate cutbacks on the type of pharmacy benefit they are offering, or eliminate pharmacy as a benefit altogether [in commercial plans]….The problem with [this] is that if an individual is unable to obtain their necessary drug therapy, you will typically see an increase in the overall health care costs associated with an individual.”

— Mesfin Tegenu, president of PerformRx, the pharmacy benefit manager division of the AmeriHealth Mercy Family of Companies, told AIS’s Drug Benefit News.

I must admit that I am more than a little skeptical of this.  The pharmacy benefit is the most used part of a benefit plan (average of 14 times per year).  Don’t you think there would be lots of other things cut back first?  Heck…I even see them cutting out 401K matching before they cut out prescription drug coverage.

Sure, it might get scaled back in terms of cost sharing or # of drugs covered, but that’s been happening for years.  But, elimination seems unlikely in a society that is very prescription drug focused.

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