Dear Colleagues,
One of the things that most of our members agree on is that our insurance benefits are superb. Everyone should have access to excellent insurance benefits, but the fact that we have them is not by accident. We have sacrificed items in negotiations to maintain a high level of benefits – in fact, it could be that they are so rich that in a few years we could be taxed on our “Cadillac plan.”
If you were to pay for our benefits, the estimated cost for a family would be over $23,000 per year and it is likely to go up 7% or more for 2016 based on our claims reports and usage.
It is in our best interest to keep costs as low as possible for things that we have control over. Here is an example:
There are 10 different common prescriptions given for upset stomach – called protein pump inhibitors. Prilosec over the counter costs our plan on average just over $37 for a 30 day supply. Prilosec over the counter costs our member NOTHING (Link to Prilosec OTC coupon) if you go to Marc’s, Rite Aid or Drug Mart because there is a coupon that allows you to get it for free even if you do not have a prescription. Better yet, the same three pharmacies allow you to get generic omeprazole for the malady and it only costs our plan around $10.
The reason why this is significant is because there are five of these protein pump inhibitors that cost the district a ton of money:
Name | Cost PER Prescription | Number of users | Cost to district Aug 2014-July 2015 |
Nexium | $528.72 | 45 | $57,630 |
Esomeprazole Magnesium | $489.35 | 29 | $23,000 |
Prevacid | $348.78 | 9 | $11,510 |
Dexilant | $421.67 | 9 | $8,433 |
Protonix | $478.67 | 1 | $2,872 |
The other 5 PP inhibitors combined | 101 | $13,510 |
So, on this one particularly popular health issue, we have the potential to save the health plan between $91,000 and $110,000 if everyone switched to either generic omeprazole or Prilosec OTC. If you use one of these medications, is there any reason why you might not try to switch to a lower cost one and see if it works as well? It won’t cost you a thing, but will save you $6 or $12 per prescription if you use the coupon. We are spending upward of $2.6 million per year on our prescription plan alone and this is only one item – imagine possible savings if we looked at other prescriptions and just got everyone to take generics when possible. I believe that if we become more aware of the true costs of our health plan then we can extend our ability to keep great health care. I will try to publish more manageable bites of information this fall for you to think about.
Hoping you don't need any of these meds,
Ari Klein
CHTU President