More employers offer preventive drug lists over time

To describe trends in employer preventive drug list (PDL) offerings and associations of employer PDL offerings with employer and workforce characteristics.

Observational and cross-sectional descriptive study.

Using a large administrative health claims database, we studied employer offering of PDLs between January 2005 and December 2017.

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).

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.