Certified Pharmacy Benefit Specialist Practice Exam

A tiered copayment structure is designed to encourage members to use lower-cost medications, typically placing higher copayments on brand-name drugs and lower copayments on generic alternatives. This structure serves as a financial incentive for members to choose generics when they are available, as they will pay less out-of-pocket for these medications.

When members are aware that opting for a generic medication can reduce their copayment significantly, they are more likely to request generics to save money. Therefore, the statement that a tiered copayment structure does not influence members to request generic medications is not accurate. The incentivization provided by such structures generally leads to increased utilization of generics, promoting cost-effective choices in medication.

In contrast, if the tiered copayment system did not exist, there may be less motivation for members to consider generics, potentially resulting in a higher overall expenditure on medications. Evaluating the effectiveness of tiered copayment systems often reveals a positive correlation with the selection of generic medications, assisting in lowering overall healthcare costs.