Mail order drug copays

[Goldenhands]

I was posed a question by my CEO the other day, and wondered if anyone else had come across it. Usually for self-insured group business there is a discount for using mail order drugs, i.e. 3 months of drugs for 2 times the copay of 1 month supply. The higher the copay, the more the savings to the employee by using this feature. At what point, or copay level, is the company at a disadvantage because they're losing out on the extra revenue? $25 was thrown out, but it wasn't a solid number. Any help is appreciated.

[Dr T Non-Fan]

The real answer is: "Who cares? They're self-insured. And the higher the copay, the more the company saves. Period. Why quibble over this?"

Now, you don't want to get fired, so here's the alternative.

I can only set it up for you, since you didn't provide all the data required:

1. Mail order is used for certain types of drugs more so than other types of drugs. The average retail drug is not the same as the average mail order drug, so the average costs of each cannot be compared or used for analysis.
2. The different dispensing fees retail vs mail, need to be considered. This is an additive cost, once per prescription, regardless of the voulme dispensed.
3. The different discounts, retail vs mail, must be considered.
4. The average one-month cost of mail order drugs, dispensed via mail order or retail, needs to be considered.

And this can be done in an Excel spreadsheet, so have a ball. I know it's possible, since I did the same thing some 10 years ago.

[mr.c]

Mail order has been slow to catch on for most of our groups, so they are still in the "Let's lose money by offering huge savings in the hopes that more people use mail order, and we can raise copays later" mode. With my current three months for one copay plan, I'm hoping that it's still quite some time before my coworkers catch on.