"Reverse Copay" Arrangements Gain Ground Among Rx Payers

The steadily rising cost of prescriptiondrug benefits is prompting a growingnumber of employers to shift to"reverse copay" arrangements. Thisswitch could leave millions of Americanspaying a bigger share of their Rxcharge out of their pockets.

Unlike traditional prescription insuranceplans, which require thepatient to pay a relatively small copayment,reverse copay arrangementswork just the opposite way. After theemployer picks up the cost of thecopay, the patient is responsible for theremainder of the prescription charge.

One recent survey found that 6% ofthe employers polled had already shiftedto reverse copay arrangements.Researchers at Hewitt Associates reportthat another 35% are now consideringthis approach.

Advocates of this strategy contendthat reverse copay arrangements donot merely shift the employer's cost tothe employee, but also they help tohold down overall drug spending bymaking patients more likely to seek outlower-priced generic alternatives.

Some drug chains welcome theshift, reasoning that profit marginstend to be higher on generics than onbranded prescription drugs.