NERA Releases Specialty Tier Study
“How Much Does that Medication Cost?” analyzed
A NERA team led by Special Consultant Dr.
- Many survey respondents were unaware that Part D insurance plans charge differently for expensive medicines used to treat complex, chronic diseases. Half of the survey respondents mistakenly believed their plan would require them to pay a co-pay rather than coinsurance for a drug on the specialty tier.
- Respondents also underestimated the amounts they would have to pay out-of-pocket for specialty tier drugs, including those used to treat rheumatoid arthritis and multiple sclerosis.
- The findings suggest that most beneficiaries are unlikely to anticipate the financial impact of being prescribed a drug on a specialty tier.
According to “How Much Does that Medication Cost?,”“while most respondents are aware that plans use tiered cost-sharing, a substantial percentage remains uninformed about the out-of-pocket costs associated with specialty tier drugs. These results suggest that, if confronted with having to take a drug on a specialty tier, many beneficiaries would be surprised to learn that they are responsible for a percentage of the cost rather than a flat co-pay. Furthermore, even those respondents who are aware that they would have to pay a percentage of the cost of a specialty tier drug underestimate the amount they would have to pay.”
The report, “How Much Does that Medication Cost?,” may be viewed at: http://www.nera.com/67_7404.htm
NERA designed a survey questionnaire that was administered by
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