EPIC Program Annual Data Tables 2007-2008: Tables IV-A and IV-B
| Description | Category | Nineteenth (2005-2006) | Twentieth (2006-2007) | Twentyfirst (2007-2008) |
|---|---|---|---|---|
| Net State Cost= (Expenditures+Premiums–Revenue) | $486,122,557 | $377,303,406 | $190,861,688 | |
| Number of Claims | Co-payment | 10,410,256 | 9,869,298 | 9,192,928 |
| Deductible | 1,107,765 | 1,371,050 | 1,477,951 | |
| Total Claims | 11,518,021 | 11,240,348 | 10,670,879 | |
| Expenditures | Total Cost of Drugs | $1,089,577,439 | $1,125,400,862 | $1,090,587,079 |
| less Third Party Payments** | $101,141,903 | $297,696,081 | $518,118,379 | |
| less Participant Co-payments | $121,075,046 | $101,573,094 | $77,150,989 | |
| less Deductible Payments | $54,171,014 | $55,386,837 | $44,412,254 | |
| Total EPIC Expenditures | $813,189,476 | $670,744,850 | $450,905,457 | |
| Plus Premium | Payments | $0 | $5,131,049 | $25,924,547 |
| Less Revenue | Manufacturers' Rebates | $295,721,272 | $263,864,871 | $226,262,168 |
| plus Participant Fees | $21,192,305 | $20,636,889 | $18,746,354 | |
| plus Claim Recovery*** | $10,153,342 | $14,070,733 | $40,959,794 | |
| Total Revenue | $327,066,919 | $298,572,493 | $285,968,316 | |
* Table IV-A represents Claims, Expenditures and Revenue by Program Year up to October 2007-September 2008.
** Estimated Third Party Payments from Medicare Part D coverage and other insurers.
*** Retroactive Third Party Claim recoveries from Medicare and other insurers.
| Paid Claims | Nineteenth (2005-2006) | Twentieth (2006-2007) | Twentyfirst (2007-2008) |
|---|---|---|---|
| Average EPIC Payment per Claim | $70.60 | $59.67 | $42.26 |
| Average Deductible Payment per Claim | $48.90 | $40.40 | $30.05 |
| Average Participant Co-payment per Claim | $11.63 | $10.29 | $8.39 |
| Average Third Party Payment** per Claim | $8.78 | $26.48 | $48.55 |
| Average Total Cost per Claim | $94.60 | $100.12 | $102.20 |
| Number of Participants Reaching Deductible | 62,511 | 63,043 | 67,301 |
| Number of Participants Reaching Copay limit | 50,900 | 31,508 | 12,189 |
* Table IV-B represents Payment and Utilization by program year up to October 2007-September 2008.
** Estimated Third Party Payments from Medicare Part D coverage and other insurers.
