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Brand-name drugs to cost CalPERS members more in 2012


SACRAMENTO—Employees and retirees who receive health benefits from the California Public Employees' Retirement System will pay more for prescription drug coverage beginning Jan. 1, 2012.

CalPERS members who request a brand-name drug when a U.S. Food and Drug Administration-approved generic equivalent is available will be required to pay the difference between the cost of the brand name drug and the generic, as well as the generic drug copayment.

In addition, copayments for retail pharmacy purchases of brand name drugs will increase by $5.

The CalPERS Board of Directors approved the increase in plan members' share of pharmacy benefit costs, partly because the portion paid by employees and retirees has decreased over the past several years while their employers' share has increased, CalPERS said Tuesday in a statement. Moreover, CalPERS members pay less than the median national copayment for preferred drugs under most other employer-sponsored benefit plans, the statement noted.

PBM switch

CalPERS also is switching pharmacy benefit managers beginning Jan. 1, 2012, from Medco Health Solutions Inc. to CVS Caremark Corp., which will give preferred provider organization plan members the new option of obtaining 90-day supplies of maintenance medications at a CVS retail pharmacy. CVS Caremark's Maintenance Choice Program also will provide CalPERS members with access to face-to-face pharmacist consultations.

CalPERS is the second-largest public purchaser of health benefits in the nation after the federal government, providing benefits to more than 1.3 million active and retired members of state and public agencies at an annual cost of nearly $7 billion.