Employers are navigating complex business challenges during the COVID-19 pandemic, including the impact on their employees’ health and wellbeing. Changes in pharmacy utilization and healthcare concerns during the pandemic are at the top of the agenda, and employers are looking for ways to manage these changes, and costs, more effectively. One important input is gathering data and evaluating trends not only to manage change but to take a more proactive approach to pharmacy management in an evolving healthcare and prescription drug landscape.

Quick Takeaways

• Asthma and chronic obstructive pulmonary disease prescriptions increased by nearly 50% from February to March 2020.
• Mental health prescriptions are also on the rise, with notable increases in drugs for anxiety, depression, and insomnia.
• Evaluating utilization and trends data can help employers plan and manage costs and access more effectively.

What The Data Show

COVID-19 is a respiratory disease, so it follows that medications for asthma and chronic obstructive pulmonary diseases would go up in utilization. We’re also seeing a rise in prescriptions for mental health medication — and these changes are significant (Figure 1).

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These data reflect a tendency to stockpile medications during a time of uncertainty as well as general concerns related to the pandemic and changes in lifestyle. Other studies have shown a lift in prescriptions for medications related to sleeplessness, in addition to anxiety and depression (Figure 2).

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Staying on top of these trends during COVID-19 can help employers make better short- and long-term decisions, as well as formulate strategies for pharmacy management.

Using The Data For Better Pharmacy Management

Employers can overlay these external data trends on top of their own utilization data to better plan and manage costs and access. To do so, employers should work with their pharmacy benefits managers (PBMs) to outline their data needs and then put a framework in place for analyzing utilization, identifying patterns, and making predictions. There could be significant shifts in utilization that were not represented during the underwriting of the PBM contract, which means employers have an opportunity to adjust contract terms.

Monitoring utilization data can also help employers get ahead of other changes.

For instance, specialty medication utilization is already expected to increase, but it may be further heightened if drugs in the pipeline end up being categorized as specialty drugs. Thus if employers are more keenly aware of their current utilization they can better assess the impact that categorization will have on their pricing. During COVID-19, it’s especially important to review the data through that lens, as there may be waves of infection that employers should plan for.

Those waves are likely to reintroduce strain on the supply chain. There are several ways employers should work with their PBMs to combat short-term shortages, ensure access to drugs, and mitigate long-term problems. Compounding medication is one measure that has already taken hold. Employers may have adjusted their plans to accommodate compounding when needed, but they should watch their data and react in real-time to rising costs. Companies can also work with their PBMs to relax utilization management restrictions and adjust quantity and refill limits. 

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During periods of uncertainty, it can be difficult to predict the needs of employees and keep their wellbeing at the forefront while managing costs. By taking a data-driven approach to pharmacy benefits management, employers can stay ahead of change and make better decisions across the organization.