Trends in employer-provided prescription-drug coverage

Monthly Labor Review

Volumn 127, Issue 8, 2004, Pages 37-45

  Dietz, Elizabeth ^a  

^a BUREAU OF LABOR STATISTICS   (United States)

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[No Author keywords available]

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EID: 20444441559     PISSN: 00981818     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Review

References (49)

1. Rachel Christensen Sethi, Employee Benefit Research Institute Issue Brief No. 265, January 2004, p. 1.
2. Centers for Medicare and Medicaid Services, on the Internet at both http://www.cms.hhs.gov/statistics/nhe/historical/t2.asp and http://www.cms.hhs. gov/statistics/nhe/historical/chart.asp, Jan. 8, 2004 (visited Mar. 26, 2004).
3. The All Items Consumer Price Index for All Urban Consumers (CPI-U; 1982-84 = 100) went from 145.3 in December 1993 to 184.3 in December 2003, an increase of 26.8 percent; the Medical Care CPI-U (1982-84 = 100) moved from 205.2 in 1993 to 302.1 in 2003, an increase of 47.2 percent; and the Prescription Drugs and Medical Supplies CPI-U (1982-84 = 100) grew from 225.7 in 1993 to 329.1 in 2003, an increase of 45.8 percent. (See Consumer Price Index Detailed Report (Bureau of Labor Statistics, December 2003), table 25, "Historical CPI for all urban consumers, 1993-2003," pp. 78-84.)
4. For more details on the differences between the EBS and the NCS, see Allan P. Blostin, "National Compensation Survey: a wealth of benefits data," this issue, pp. 3-5. Additional information about the benefits portion of the NCS can be obtained on the Internet at http://www.bls.gov/ncs/ ebs/home.htm.
5. According to National Compensation Survey: Employee Benefits in Private Industry in the United States. 2000, Bulletin 2555 (Bureau of Labor Statistics, January 2003), table 94 (p. 79) and table 96 (p. 81), only 13 percent of part-time workers had prescription-drug coverage, while 59 percent of full-time workers had such coverage. In 2003 - to pick a representative year - 95 percent of the participants in medical insurance plans were full-time workers.
6. Employee Benefits in Small Private Establishments, 1996, Bulletin 2507 (Bureau of Labor Statistics, April 1999), pp. 39, 56-57;
7. and Employee Benefits in Medium and Large Private Establishments, 1997, Bulletin 2517 (Bureau of Labor Statistics, September 1999), pp. 4, 42-43, 71-72.
8. Centers for Medicare and Medicaid Services, on the Internet at http://www.cms.hhs.gov/statistics/nhe/historical/highlights.asp, Jan. 8, 2004 (visited Mar. 26, 2004).
9. Prescription Drug Trends: A Chartbook Update, Kaiser Family Foundation, November 2001, Exhibit 13, p. 27.
10. Sethi, Brief No. 265, p. 1.
11. IMS health and expenditure data. Centers for Medicare and Medicaid Services, on the Internet at http://www.cms.hhs.gov/statistics/nhe/default.asp, cited in Kaiser Family Foundation,
12. Prescription Drug Trends, Fact Sheet 3057-02, May 2003, on the Internet at www.kff.org (visited Mar. 26, 2004).
13. "Health Spending Projections for 2002-2012," in Health Affairs, Feb. 7, 2003, on the Internet at http://www.healthaffairs.org, cited in Kaiser Family Foundation,
14. Prescription Drug Trends, Fact Sheet 3057-02.
15. Employee Benefit Research Institute, EBRI Notes, March 2004, Figure 3, p. 10.
16. Health, United States, 2003, with Chartbook on Trends in the Health of Americans (Hyattsville, MD, National Center for Health Statistics), September 2003, table 127, pp. 326-28.
17. Prescription Drug Coverage, Spending, Utilization, and Prices: Report to the President (U.S. Department of Health and Human Services, April 2000), cited in Kaiser Family Foundation,
18. Prescription Drug Trends, Fact Sheet 3057-02.
19. Employer Costs for Employee Compensation Historical Listing (Quarterly) 2002-03 (Bureau of Labor Statistics, Feb. 26, 2004), table 3, p.11.
20. Strazewski, Len, "Prescription Drug Cost Containment: Attacking rising health care costs one piece at a time can pay dividends," Benefits Business, February 2003; on the Internet at http://www.roughnotes.com/ rnmagazine/2003/february03/02p76.htm (visited Mar. 26, 2004).
21. The term "medical coverage" is used throughout the remainder of this article to refer to coverage for medical conditions, such as hospitalization, physician visits, and other goods and services typically covered by medical plans. Included among such coverage is that for prescription drugs. Separate coverage for dental or vision care was excluded from the analysis.
22. Employee Benefits in the United States, 1992-93 (Bureau of Labor Statistics, March 1995), table titled "Percent of employees participating in selected benefits, by private and public sectors and full-time and part-time status, United States, 1992-93," inside front cover; and
23. National Compensation Survey: Employee Benefits in Private Industry, 2003 (Bureau of Labor Statistics, forthcoming).
24. Due to changes in survey methodology, the percentage of workers participating in medical care in 2003 excludes 8 percent of workers who had some type of coverage (medical, dental, vision, or some combination) that could not be identified in the survey data collection process. Omitting these workers may serve to exaggerate the decline in medical care coverage. In his article, "New statistics for health insurance from the National Compensation Survey" (this issue, pp. 46-50), Michael Lettau imputes a coverage type for the 8 percent of workers with missing data. He shows that, after imputation, 51 percent of workers had medical care coverage in 2003.
25. In-hospital drugs are prescription drugs provided to hospital patients and are usually covered under the patient's medical plan as part of hospital room and board.
26. Information on precertification and step therapy is available on Aetna's Internet site, http://www.aetnapharmacy.com.
27. Sethi, Brief No. 265, p. 8.
28. Fundamentals of Employee Benefit Programs, 5th ed. (Washington, DC, Employee Benefit Research Institute, 1997), pp. 228-29.
29. See, for example, Benefit News Advisor, Jan. 28, 2004, on the Internet at http://www.benefitnews.com/detail.cfm?id=555-4&terms= |00||ar||96||95||cards||eb||d2||011|99||prescription||nw||97||98| (visited May 21, 2004).
30. Kaiser Family Foundation and Health Research and Educational Trust, Employer Health Benefits, 2000-03 annual surveys,
31. as reported in Sethi, Brief No. 265, p. 34.
32. Prescription Drug Trends - a Chartbook Update (Menlo Park, CA, and Washington, DC, Kaiser Family Foundation, November 2001), Exhibit 13, p. 27.
33. Kaiser Family Foundation and Health Research and Educational Trust, Employer Health Benefits, 2000-03 annual surveys,
34. as reported in Sethi, Brief No. 265, Figure 11, p. 32.
35. See Employee Benefits in Medium and Large Private Establishments, 1993, Bulletin 2456 (Bureau of Labor Statistics, November 1994), table 84, p. 77;
36. Employee Benefits in Medium and Large Private Establishments, 1997, table 83, p. 71;
37. National Compensation Survey: Employee Benefits in Private Industry in the United States, 2000, table 34, p. 34.
38. For more information on mail-order prescription drugs, see Cathy Baker and Natalie Kramer, "Employer-sponsored prescription drug benefits," Monthly Labor Review, February 1991, pp. 31-35.
39. 2002-03 NCS data on employee participation in plans with network pharmacy incentives are not included in this article because the data did not meet BLS standards.
40. 2002-03 NCS data on employee participation in indemnity and prepaid plans with copayments for brand-name prescription-drug coverage are not included in this article because the data did not meet BLS standards.
41. The 1993 EBS and 2002-03 NCS published data, not on the average copayment per prescription, but rather, on the percentage of employees whose plan requires a copayment at a particular level.
42. 2002-03 NCS data on employee participation in indemnity and prepaid plans by copayment level for brand-name prescriptions are not included in this article because the data did not meet BLS standards.
43. Averages exclude those workers who are not required to make a copayment. The 1997 and 2000 figures are for full-time employees only, and the 1997 figure includes only workers in establishments with 100 or more employees. The 2000 and 2002-03 figures include workers in all sizes of establishments.
44. 2002-03 NCS data on employee participation in indemnity and prepaid plans with this feature were not included in this article because the data did not meet BLS standards.
45. Center for Financing, Access and Cost Trends, Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey Household Component, 1997-2000, Figure 6, "Average Utilization for Outpatient Prescription Drugs for Those with a Purchase by Age, 1997-2000," on the Internet at http://www.meps.ahrq.gov/papers/st21/stat21.htm (visited Mar. 26, 2004).
46. The Medicare Prescription Drug, Improvement, and Modernization Act of 2003, Public Law 108-173. was signed into law on December 8, 2003. For an analysis of this recently passed legislation, see "Prescription Drug Coverage for Medicare Beneficiaries: An Overview of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003" (Washington, DC, Health Policy Alternatives, Inc., for the Henry J. Kaiser Family Foundation, Jan. 14, 2004).
47. Sethi, Brief No. 265, pp. 6-8.
48. When it is fully implemented, the NCS will include workers in State and local government establishments of all sizes.
49. Centers for Medicare and Medicaid Services, Jan. 8, 2004; on the Internet at http://www.cms.hhs.gov/statistics/nhe/historical/highlights.asp (visited Mar. 26, 2004).