Commission to Change Employee Drug Plan

Belmont County commissioners indicate they will approve a change in the drug prescription plan for county employees that is expected to financially benefit the county by more than $100,000 each year.

Earlier this year, commissioners balked when Express Scripts – the county’s pharmaceutical insurer – presented the county with an option that eliminated 48 drug products from the National Preferred Formulary list provided for in the county’s coverage. They decided then they wanted county employees to have coverage for these drugs.

But Thursday, commissioners changed their mind after hearing details from Mark Schwendeman, president of the Schwendeman Agency, who serves as an insurance broker and consultant for Belmont County.

Schwendeman said staying with the National Preferred Formulary would bring the county a 25 to 30 percent increase in annual rebates for prescription drugs from pharmaceutical companies. Belmont County received $80,177 in rebates for 2013, according to Schwendeman. He estimated the rebate increase over last year’s figure for the county would come to $24,053.

Additionally, the county would lose 20 to 30 percent in rebates based on the $80,177 figure if it chose not to go with the National Preferred Formulary, Schwendeman said. That would mean a $24,053 loss to Belmont County.

Express Scripts estimates Belmont County would pay out an additional 14 percent in claims next year if they chose to provide a plan that offers the eliminated drugs. The county paid out $743,023 in claims this year, and the eliminated drugs accounted for 60 percent of the figure – or $445,813. This could mean an additional $62,412 in claims based on the 14 percent increase prediction, Schwendeman said.

He added together the $62,412 expected pay out in claims and the $24,053 in expected loss in rebates to determine the county first would lose $86,465 if it chose not to sign on to the National Preferred Formulary List plan. On top of this, Belmont County would not receive the expected $24,053 in rebate increases if they joined the plan.

Schwendeman then set the cost benefit to Belmont County at $110,518.

Under the National Preferred Formulary Plan, members would have access to generic and alternative forms of the drugs eliminated, he added. In addition, those needing the excluded drugs could have them covered if they submitted a letter to Express Scripts stating the reason for the necessity.

Schwendeman told commissioners they needed to inform Express Scripts of their decision prior to Dec. 20. But commissioners indicated they would pass a motion next week keeping the county with the National Preferred Formulary plan.