“Brand-Name and Generic Prescription Drug Use After Adoption of a Full-Replacement, Consumer-Directed Health Plan With a Health Savings Account,” and “How Would Defined Contribution Participants React to Lifetime Income Illustrations? Evidence from the 2014 Retirement Confidence Survey”

March 2014, Vol. 35, No. 3
Paperback, 16 pp.
PDF, 851 kb
Employee Benefit Research Institute, 2014

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Executive Summary

Brand-Name and Generic Prescription Drug Use After Adoption of a Full-Replacement, Consumer-Directed Health Plan With a Health Savings Account



  • A full-replacement HSA plan was associated with a 4.7 percentage-point rise in the generic-drug dispensing rate (GDR) after one year, and settled 3.4 percentage points higher after four years. The GDR for maintenance medications experienced a similar effect, while for nonmaintenance conditions the GDR rose by 4.1 percentage points after one year, but was just 1.7 percentage points higher after four years.
  • At the end of the four-year follow-up period, GDR was greater by 4.5 percentage points for hypertension, 15.4 per-centage points for dyslipidemia, and 7.8 percentage points for asthma/COPD. No significant effects were detected for diabetes GDR, but the measure for depression was lower by 8.4 percentage points after 2010.
  • GDR increases were due to individuals discontinuing use of brand-name drugs without substituting generic therapy. After one year under the full-replacement HSA plan, 0.43 fewer generic and 0.95 fewer brand-name prescriptions were filled, on average.

How Would Defined Contribution Participants React to Lifetime Income Illustrations? Evidence from the 2014 Retirement Confidence Survey



  • In May 2013, the U.S. Department of Labor's Employee Benefits Security Administration (EBSA) published an advance notice of proposed rulemaking (ANPRM) focusing on lifetime income illustrations. The 2014 Retirement Confidence Survey (RCS) included a series of questions concerning monthly income illustrations similar in many respects to those provided by the EBSA’s online Lifetime Income Calculator.
  • The vast majority of respondents said the retirement income projection was useful; more than 1 in 3 (36 percent) of the respondents thought that it was very useful to hear an estimate of the monthly retirement income they might expect from their plan, and another 49 percent thought it was somewhat useful.
  • A total of 17 percent of the respondents indicated that this information would lead them to increase the amount they were contributing. However, of those responding that their illustrated value was much less or somewhat less than expected, 35 percent indicated they would increase their contributions.