Bronze-Level Prescription Drug Copays Are Much Higher in 2015, New AIS Database Finds

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Bronze-level plans have the biggest increases, on average, in prescription drug copays for in-network retail fills on all formulary tiers, according to data from Atlantic Information Services’s new online resource, Rx Benefit Design Data.

Drug copays on all formulary tiers for bronze-level health plans sold on public exchanges for the 2015 plan year are much higher compared with 2014, according to research from Atlantic Information Services, Inc.’s (AIS) Rx Benefit Design Data (RxB), a new online database on drug benefit parameters of commercial health plans.

According the data in RxB, published in a recent issue of AIS’s Drug Benefit News, drug copays for bronze-level plans now average $18.59 for generics, a 30.55% increase over the 2014 amount; copays for generics on silver-level plans saw a only 1% increase while generics on gold- and platinum-level plans are both 2% lower than last year. Copays for bronze-level preferred, non-preferred and specialty prescriptions are also higher compared with 2014, with 42%, 58% and 88% increases, respectively.

To read the article of Drug Benefit News in which this research appeared, including charts comparing average copays per formulary tier and metal level for plans on individual exchanges in 2014 and 2015, and percentage change from 2014 in average prescription copays, visit http://aishealth.com/archive/ndbn121914-05.

Sources for RxB include summary of benefits and coverage documents that are legally required to be available for all ACA-compliant qualified health plans. AIS researchers obtain these documents from insurers and exchanges, examine them and carefully select the relevant data for each field. Additional research is performed to clarify, complete, supplement and rearrange the information into a comparable data format.

RxB was developed by researchers in AIS’s Directory and Databases Division, the company’s exclusive in-house research team that also creates the industry-leading AIS’s Directory of Health Plans. AIS designed the user-friendly RxB database to quickly retrieve the details of prescription drug benefit offerings of each insurer on and off public insurance exchanges, with options to sort by plan name, plan type and metal tier, for both Small Business Health Options Program (SHOP) and individual exchanges. The data include out-of-network amounts and limits where applicable.

For more information and to use a fully interactive demo of the product, visit http://www.AISHealthData.com/RxB.

About Atlantic Information Services
Atlantic Information Services, Inc. (AIS) is a publishing and information company that has been serving the health care industry for more than 25 years. It develops highly targeted news, data and strategic information for managers in hospitals, health plans, medical group practices, pharmaceutical companies and other health care organizations. AIS products include print and electronic newsletters, websites, looseleafs, books, strategic reports, databases, webinars and conferences. Learn more at http://AISHealth.com.

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Susan Namovicz-Peat, Director, Directories and Databases Division
Atlantic Information Services
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