Top 5: Causes of Changing Prescription Costs #1

1. How often your prescription plan carrier reviews the pricing of medications

The price of prescription medications is constantly changing based on a variety of factors. Anthem has compared the rise and fall of prices to gas or hotel rooms. The frequency that your insurance carrier audits the cost of prescriptions can mean significant impact for you.

For instance, some carriers only check the price of medications on a bi-annual basis while others check on a monthly basis. As a member, this can impact the total out of pocket throughout the year.

	Prescription Cost	Price to Member with bi-annual review	Price to member with monthly review
January	50	50	50
February	75	50	75
March	100	50	100
April	100	50	100
May	100	50	100
June	100	50	100
July *biannual review month	100	100	100
August	75	100	75
September	25	100	25
October	25	100	25
November	25	100	25
December	25	100	25
Total Cost		950	800

In this example, the member on the bi-annual plan has more consistency in their cost, but their final year out of pocket is $950. The member on the monthly review plan has costs all over the place, but their final year out of pocket is only $800. This can go either way for the member, but the frequency that the plan reviews this cost can impact the consistency of the prescription pricing as well as the out of pocket cost to the member.

For more examples of the causes of changing prescription costs, check out our Top 5: Causes of Changing Prescription Costs and check back often for articles explaining further each of these examples.