Rising drug costs and the need for uniformity in coverage were both cited as reasons behind a new plan to provide all University faculty and staff with prescription drug coverage separate from University medical insurance plans.
The Senate Advisory Committee on University Affairs discussed the plan yesterday at their weekly meeting. It will go into affect next year.
Two committees, the Prescription Drug Program Oversight Committee and the Pharmaceutical Benefit Advisory Committee, were responsible for assisting the University Benefits Office in selecting AdvancePCS, a leading national pharmacy benefit manager, as the new provider for the program.
“It really is essential for the University to take control of the pharmaceutical experience of its participants,” PDPOC Chair John Billi said.
Under the new plan, which will take effect on Jan. 1, members will be granted access to the same prescription drugs available under the current plan.
But the plan features a new three-tier co-payment for drug purchases, in which prices differ for generic drugs, preferred brand drugs and selected brand name drugs.
Other new options available under the plan include new coverage of psychiatric drugs, a mail order service for large quantities of medications, a point-of-sale drug card for all participants and early refills to synchronize prescriptions during the first year.
Some SACUA members expressed concern that certain types of drugs, such as weight loss medications, are not covered under the plan.
Billi said some drugs were not covered because of questions about their safety and effectiveness.
The plan’s emphasis on increasing the use of generic drugs to cut costs also raised concerns that members would not have the best medications available to them.
Billi said brand name drugs would be available when appropriate, though at a higher cost than generic drugs in some cases.
According to the Benefits Office, AdvancePCS was chosen from a group of finalists representing the largest and most sophisticated pharmacy benefit management companies in the nation because of its competitive pricing, flexibility and experience with the University.
“I think it’s the best that the University can do to make sure our faculty and staff have the most access to the opportune level of drugs based on the interaction between the physician and the patient,” Director of Benefits Marty Eichstadt said.
Eichstadt said she liked that “the University was able to decide what drugs would be covered not just based on price but based on outcome.”
She added her office has been working on the new plan for the past two years.
Many of the features of the new program, including the tiered co-payment system, were recommendations made as a result of a series of focus groups led by Prescription Drug Work Group 2002.
Former Provost Nancy Cantor and Robert Kasdin, former executive vice president and chief financial officer, created the Prescription Drug Work Group 2002 in late 2000 to examine prescription drug coverage in University health plans.