Health Insurance Exchange Plans - Drug Trend Report

HIX

Setting a steady course for the future of exchange plans

As the public health insurance exchanges completed their third year of operation in 2016, the marketplace continued to struggle with only modest growth in enrollment and an unsettled population with costly conditions.

Chronic, costly conditions continued to drive benefit usage with specialty medications accounting for nearly half of total drug spending among exchange plans. However, there are signs that suggest benefit usage is expanding beyond the chronically ill.

As lawmakers and the industry grapple with the best way to provide healthcare for all, we see opportunities in our analysis that can help insurers mitigate challenges in offering affordable and comprehensive plans for exchange members. By optimizing pharmacy benefits, we can reduce costs for plans, which can help lower premiums and total costs for patients.

Whether the current system is ultimately amended or replaced, we believe advanced pharmacy benefit solutions must be part of the discussion and the way forward. We look forward to working with our exchange plan clients to make that happen.

Read our full report on Health Insurance Exchanges.

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