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Economic Conditions Signal Long-Term Shift in Rx Benefit Approach

FRANKLIN LAKES, N.J., Sept. 14 /PRNewswire-FirstCall/ -- According to a new survey released today, 90 percent of plan sponsors believe that minimal attention to personal health and increased incidence of chronic illness such as diabetes and heart disease are at the root of rising health care costs. When asked what influences will have the greatest impact on controlling these escalating costs, nearly 60 percent of respondents say embracing the concept of wellness will yield the most savings, citing the need to control preventable and self-inflicted diseases often linked to obesity and smoking.

The survey, a national peer study of prescription benefit management, was conducted on behalf of Medco by the Healthcare Division of Haldy McIntosh and Associates and polled 300 plan sponsors with between 500 and 50,000+ employees in the first quarter of 2009. It included private and public sector employers and labor unions. The results are reported in the third annual edition of 9 Leading Trends in Rx Plan Management.

"This survey shows that plan sponsors recognize that prevention is key to reducing costs and are looking for approaches that will help employees embrace the concept of wellness, adopt healthier habits, and follow doctors orders when it comes to taking essential medications," said Tim Wentworth, Group President of Medco's Employer Accounts. "A large percentage of our health care dollars are being spent on treatments for diabetes, cholesterol and hypertension - conditions that in many cases could be better controlled, and even prevented, by changing behaviors."

According to a study just published in the journal Health Affairs, obesity-related conditions cost the U.S. $147 billion in direct medical spending in 2008. The study cites the rising rate of obesity as the single greatest contributor to the country's diabetes epidemic.

In addressing the growing problem of chronic disease, plan sponsors are increasingly looking to integrate pharmacy and medical data to help improve health and financial outcomes. In fact, 80 percent of organizations plan to integrate drug and medical data, while 73 percent intend to add clinical management programs to their pharmacy benefit to help increase patient safety and control plan costs.

"Integrating both medical and prescription claims data is a key strategy in helping to control costs related to chronic and complex conditions," said Mike Romanzo, R.Ph., President of Medco's Systemed Group. "It facilitates identifying medication adherence and safety issues. Pharmacists can then counsel patients to reduce the chances of more serious health problems and additional costs."

Additional survey highlights include:

  • Specialty SOS - For the second year in a row, specialty medications are seen as the leading driver of prescription drug costs, and 83 percent of plan sponsors support quick legislative action to bring generic versions of specialty drugs to market. More than 75 percent of plan sponsors have found some relief through reduced prices by billing these drugs under the pharmacy benefit instead of the medical benefit.
  • Mail order improves adherence - Seventy percent of plan sponsors believe that mail-order pharmacies help members stick to essential drug therapies and nearly half believe that mail-order pharmacists do a better job at identifying adherence problems. Increased medication adherence results in better health outcomes and lower overall healthcare costs. For example, a recent Medco study found that annual healthcare costs for hypertensive patients using mail order saw a $700 per-patient reduction due to increased adherence to prescribed drug therapy.
  • Low-cost retail generics programs fall short - While there is unanimous agreement that generics provide significant cost savings, 62 percent of respondents believe that the much-publicized $4 generics programs at retail pharmacies are merely designed to increase foot traffic, and represent only a limited number of available generic drugs.
  • Pharmacogenomics goes mainstream - More than 60 percent of plan sponsors believe that genetic testing should become a routine part of health care, with larger companies leading the trend in covering these tests - nearly half provide coverage while only 14 percent of smaller companies do.

Further details on these and other emerging trends are available in the 2009 edition of 9 Leading Trends in Rx Plan Management: Findings from a National Peer Study. To receive a free copy of the report, visit

About Medco

Medco Health Solutions, Inc. (NYSE: MHS) is pioneering the world's most advanced pharmacy(R) and its clinical research and innovations are part of Medco making medicine smarter(TM) for more than 60 million Americans.

With more than 20,000 employees dedicated to improving patient health and reducing costs for a wide range of public and private sector clients, and 2008 revenue exceeding $51 billion, Medco ranks 45th on the Fortune 500 list and is named among the world's most innovative, most admired and most trustworthy companies.

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This press release contains "forward-looking statements" as that term is defined in the Private Securities Litigation Reform Act of 1995. These statements involve risks and uncertainties that may cause results to differ materially from those set forth in the statements. No forward-looking statement can be guaranteed, and actual results may differ materially from those projected. We undertake no obligation to publicly update any forward-looking statement, whether as a result of new information, future events, or otherwise. Forward-looking statements in this press release should be evaluated together with the risks and uncertainties that affect our business, particularly those mentioned in the Risk Factors section of the Company's Annual Report on Form 10-K and Quarterly Reports on Form 10-Q filed with the Securities and Exchange Commission.

SOURCE Medco Health Solutions, Inc.
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