MarketW a t c h Impact Of Health Plan Design And Management On Retirees' Prescription Drug Use And Spending, 2001 Plans with aggressive cost sharing lowered health plan spending but cost retirees more, this study finds.

We examined 2001 prescription drug claims for a range of employer-based re- tiree plans administered by a national pharmacy benefit management firm, to understand how use and spending differ with various cost-sharing approaches and other drug use man- agement techniques among the elderly. In these plans, most of which had generous bene- fits and substantial use of mail order, more aggressive cost-sharing requirements com- bined with other management strategies were associated with greater member cost sharing, a shift to less costly medications (generic and mail order), and lower total prescrip- tion drug spending. Although we did not find lower rates of use in plans with aggressive cost sharing, this may be attributable in part to their higher drug use associated with mail-order incentives.