Respondents were far less likely this year than in previous surveys to select direct-to-consumer (DTC) advertising as the primary culprit in rising prescription benefit costs. For the first time in the survey's history, DTC came in only slightly ahead of the expense of developing new drugs as the most significant factor.

The survey also found that employers believe co-pays should be higher. Three-quarters of respondents feel that a member's co-pay should be 30% or less, compared to 20% or less in previous years' surveys. And, they continue to pass the cost increases along to their employees. When asked about co-pays in reality, only 58% of respondents' answers were in the 30% or less categories compared to 88% the previous year.

“The most concerning aspect of this trend is that it is a short-sighted solution,” notes Arxcel CEO Chris Robbins. “Not only does it place a greater burden on employees, but it does nothing to affect industry pricing. Until employers begin to scrutinize their premiums and the pricing associated with their prescription benefit programs, as well as encourage employee behaviors that actually reduce costs, they can expect to keep seeing significant annual increases.”

The opinions gathered regarding access to drugs from Canada were quite strong—though not surprising—given the significant attention the media has paid to this subject. Seven in 10 respondents felt American citizens should be allowed to purchase prescription drugs legally from Canada. With 13% being undecided on the issue, only two in 10 felt Americans should not have such access.

Respondents were less sure on the topic of quality or safety concerns related to prescription drugs coming from Canada. While 52% felt there were no such concerns, 45% felt such concerns were legitimate, and 3% were unsure.

Full survey results will be available on www.arxcel.com later this year. To register to receive notification of the survey's availability, click here.

Choosing the Right Rx

The vast majority of Americans rely on prescription drugs to improve and maintain their quality of life. Whether it is an occasional antibiotic or a slew of medications taken on a daily basis, nearly everyone depends upon drug therapy.

The cost associated with a drug regimen can be a burden to the payer(s). Many employer pharmacy benefit plan sponsors have passed on their increased costs to employees by way of higher premium contributions, increased cost share in their plan's copayment/coinsurance structure or both.

An effective plan design will result in a member cost share of approximately 25 to 33%. Such an arrangement will encourage the use of the lowest cost, most highly effective drug therapy. In addition, programs such as a Mandatory Generic Program, Step Therapy and Prior Authorization will encourage the use of the most appropriate drug for the patient.

These are some of the things that a plan sponsor can do to help control costs…but what can an individual do to help control costs?

Everyone is responsible for their own health and related health care. First and foremost, the best offense against many of the chronic conditions that require medication is living a healthy lifestyle. Everyone needs to eat properly, get plenty of rest, exercise, drink water, limit alcohol consumption and avoid tobacco products.

Many employers offer health and wellness programs that encourage a healthy lifestyle by offering classes on stress management, nutrition, smoking cessation and the like. These may not always be enough. Other factors such as genetics, heredity and the environment may affect an individual's predisposition to certain conditions that require drug therapy.

We are lucky to have so many products to choose from to help. The key to this is choice.

Many chronic conditions such as hypertension, high cholesterol and diabetes have several drugs that can effectively treat each condition. This can be overwhelming and confusing to some.

There are sources providing information on drugs for the treatment of certain conditions sponsored by highly recognized and credible organizations available to anyone looking for such data. These sources compare each drug by cost and effectiveness.

The first is AARP's “ Effectiveness and Safety of Prescription Drugs ” at www.aarp.org/researchRx. The site is user friendly and provides information by drug or condition. The site details the condition, the class(es) of drugs that are used to treat the condition, then offers a cost comparison. Below is a table from the site that compares the cost of Proton Pump Inhibitors.

Another site that provides excellent information is Consumer Reports Best Buy Drugs at www.crbestbuydrugs.org. Consumer Reports Best Buy Drugs is a public education project of Consumers Union, the publisher of Consumer Reports. Consumers Union is an expert, independent, nonprofit organization that prepares reports to evaluate the effectiveness, safety and costs of drugs, allowing the patient and the doctor to work together to decide the best course of treatment for the patient.

Everyone has the ability to effectively and consistently manage cost and quality issues pertaining to prescription drug costs with a little research.

FDA Updates

Tsabari, a specialty injectable medication for the treatment of relapsing forms of multiple sclerosis was approved by the FDA in November 2004. On February 28, 2005 Biogen Idec and Elan announced that they would voluntarily stop sales and marketing efforts of the product due to two serious adverse reports in patients taking Tsabari with Avonex. The companies have advised doctors to stop prescribing Tsabari.

On March 4, 2005 the FDA seized batches of GlaxoSmithKline's Paxil CR and Avandamet, citing concerns that the drugs did not meet the FDA's standards for safety and quality.

Paxil CR is a controlled release version of the anti-depressant drug Paxil. Avandamet is used for the treatment of Type 2 diabetes.

During routine inpections of the manufacturing sites, the FDA noted significant violations of FDA's standards. Subsequent inspections revealed that the violations had not been adequately resolved.

The FDA inspections indicated that some of the Paxil CR tablets could split apart. This could cause a patient to take a tablet that does not contain the active ingredient or the intended controlled release effect.

Avandamet tablets were not manufactured uniformly and did not contain the appropriate doses of one of the active ingredients.

The FDA has stated that it “does not believe that the products in question pose a significant health hazard to consumers.” The medications will continue to be stocked in pharmacies but the FDA urges patients to speak to their physicians about alternative medications.