The Rising Cost of Drug Prices: What Blue Cross is Doing and How It Impacts Members


| 3 min read

prescription drugs
Drug giant Pfizer recently announced it will raise prices for about 10 percent of its drugs in early 2019, with most increases being between three and nine percent. As a Blue Cross Blue Shield of Michigan member, you might wonder how this news will affect you. We want to let you know what Blue Cross is doing to help combat rising drug costs—and how it may impact you as a member. Though Pfizer didn’t name specific drugs that would be involved in the increases, this type of announcement happens somewhat regularly. In fact, drug price increases between three and 10 percent are fairly common. That said, Blue Cross prepares as much as possible for price increases such as these. Our pharmacists diligently work behind the scenes, using analytics, reports, clinical reviews and more to ensure members have access to safe, high-quality prescription medications. So, when a pharmaceutical company like Pfizer announces price increases, we already have processes in place to evaluate our drug offerings and ensure we continue to provide our members access to the most cost-effective drug therapy. What does that mean for you? When increases like this happen, our goal is to ensure members do not experience notable changes in their premiums. There are a few ways large price hikes could affect members, including potentially higher copays, quantity limitations or requiring prior approvals for a medication. In extreme cases, it could even result in the drug not being covered (in that case, members will have access to alternate medications). Ideally, none of these things would happen, but if they did, Blue Cross would communicate these changes to members ahead of time to allow members to discuss alternative treatment options with their providers. Blue Cross puts these changes in place when lower cost options are available that work just as well as high cost drugs. Controlling drug spend this way helps keep premiums at a reasonable level. If you want to learn more about what lower-cost alternatives you can use for expensive drugs, take a look at the following resources. You can also log in to your member account to price a drug and find alternatives, call the number on the back of your Blue Cross ID card, or speak with your primary care physician for more assistance.
  • To find alternatives to non-preferred drugs on our Custom Drug List, click here.
  • To find alternatives to drugs that aren’t covered on any of the commercial Blue Cross Blue Shield of Michigan or Blue Care Network drug lists, click here.
  • To find alternatives to drugs that aren’t covered on the Custom Select Drug List, click here.
For more information on prescription drugs, check out these additional blogs:
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