New Therapies Bring New Challenges to Drug Benefit Design

With many new, expensive treatments entering the U.S. market, plan sponsors are facing more challenges when designing their drug benefits packages, according to Pharmaceutical Strategies Group’s 2023 “Trends in Drug Benefit Design Report,” sponsored by Rx Savings Solutions. The report is based on surveys of 180 individuals representing employers, health plans and union/Taft Hartley plans.

In 2023, almost all employers and health plans offered a preferred provider organization (PPO) plan and most offered a high-deductible health plan (HDHP) with a health savings account (HSA). Yet only 43% of respondents agreed or strongly agreed that HDHPs effectively manage overall drug trend. The percentage showed a modest increase compared to 35% in 2022.