More employers offer preventive drug lists over time.

OBJECTIVE: To describe trends in employer preventive drug list (PDL) offerings and associations of employer PDL offerings with employer and workforce characteristics. STUDY DESIGN: Observational and cross-sectional descriptive study. METHODS: Using a large administrative health claims database, we studied employer offering of PDLs between January 2005 and December 2017. RESULTS: The percentage of employers offering PDLs increased between 2005 and 2017, and this was most pronounced among larger employers. In 2017, almost 43.0% (95% CI, 35.7%-50.1%) of employers with 5000 or more insured employees offered PDLs, 4 times more than employers with 50 to 199 employees (10%; 95% CI, 9.3%-10.3%). Among employers with at least 85% of their insured workforce in high-deductible health plans with health savings accounts (HDHP-HSAs; n = 24,632; 8.9%) across the study period, 32.0% offered PDLs in the last benefit year, and 13.0% of non-HDHP-HSA employers did. In adjusted analyses, HDHP-HSA employers with older workforces (OR, 1.45; 95% CI, 1.43-1.48) and those with more chronically ill employees (eg, more than 75% of employees with diabetes) (OR, 1.20; 95% CI, 1.17-1.23) were more likely to offer PDLs than employers with workforces living in poorer neighborhoods (OR, 0.79; 95% CI, 0.77-0.81). CONCLUSIONS: More employers offered PDLs over time, particularly large employers and employers with most employees in an HDHP-HSA. These findings suggest an encouraging trend toward improved health care access among commercially insured adults.

Duke Scholars

Author J. Franklin Wharam Medicine, General Internal Medicine