Categories: Fedweek

Prescription Drugs Remain a Focus

On prescription drugs, OPM noted that carriers in general now have programs to control costs such as requirements for additional authorization for certain drugs, and mail order and retail programs that offer 90 day supplies of maintenance medications. OPM further noted that plans are moving to a four-category system — of generics, preferred brands, non-preferred brands and specialty drugs – designed to improve understanding of prescription drugs; by 2016, all plans will have to make available a prescription drug cost calculator for current and prospective enrollees. It encouraged plans to continue those efforts and in addition said that by 2016 they should consider excluding certain drugs on grounds they are less effective or less safe than others available, or that cost substantially more for little additional benefit. OPM meanwhile told agencies in a memo to prepare for the upcoming self-plus-one option to be available starting that same year.

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