Over-the-Counter Benefits Programs Are Good for Everyone

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By Admin May 17, 2023

Not every medical situation requires a visit to the doctor and a prescription medication. As you know, sometimes you simply need to stop at the pharmacy and pick up an over the counter (OTC) medication.

As you might imagine, the ability to conveniently purchase needed OTC medications provides convenience to enrollees, but outcomes are good for healthcare plans as well. Just some of the reported statistics include:

  • The Centers for Medicare & Medicaid Service (CMS) Risk Score is lower for OTC benefit users compared to non-users.
  • Certain populations using an OTC benefits program show lower medical costs, reduced use of hospitals, and better health outcomes.
  • Medical costs among obese patients with OTC benefit plans are 62 percent lower than those without OTC benefit plans.
  • Patients with substance abuse disorders lower costs by 29 percent when using an OTC benefit plan.
  • OTC benefit plan users who purchase eye and ear care products have 13 percent lower hospital admissions rates and 8 percent lower medical costs.
  • OTC benefit plan users diagnosed with stroke have hospital admission rates 10 percent lower than non-users and enjoy 23 percent lower prescription drug costs.

Lower hospital admission rates and overall costs benefit everyone by keeping plan costs low. Feel free to contact us if you have questions or if you would like additional information.


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