Humana Pharmacy Solutions has created a new pharmacy plan designed to save employers money, while also maintaining choice for their employees. Called Rx4Value, it encourages people to use generic drugs, which are less expensive than their brand-name counterparts. However, Rx4Value also provides a $15 allowance for non-preferred brand-name medications.
The Rx4Value formulary is divided into the following four tiers:
Developed in accordance with U.S. Pharmacopeia's evidence-based standards, the formulary includes at least two drugs in each category/class and at least one drug in each key drug type. The cost for covered drugs varies from a copayment to coinsurance.
The $15 allowance for non-preferred brand-name medications is roughly equivalent to the cost of a generic drug. The member pays the difference between the allowance and Humana's negotiated price of the drug. This differs from straight closed formularies that offer no coverage for non-preferred drugs. Employers can start with a higher allowance and change the allowance over time to move more members toward preferred drugs.
Rx4Value helps everyone save
"The design will encourage people to use lower-cost alternative prescription drugs, driving savings for everyone," said William Fleming, PharmD., Vice President of Humana Pharmacy Solutions. "Our experience has shown that approximately 85 percent of members who are taking a drug that would receive an allowance will move to a lower-cost alternative."
Compared with other plan designs, Rx4Value can save employers up to 25 percent of what they spend on prescription drugs.
"So many blockbuster brand-name medications have gone generic that it now makes sense to offer a plan like this," Fleming said. "Plus, it gives some coverage to those who choose to stay with the non-preferred drugs. In addition, while some plans offer closed formularies that make certain drugs unavailable, we strive to live up to our brand promise of 'guidance' without removing choice."
For more information on Rx4Value, contact your Humana representative.