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Managed trend -- or drug-trend growth net of copayment -- for those plan sponsors who had at least one trend-management program by 2003 was 10.4%. As shown in the following exhibit, plan sponsors that implemented one or more tools for the first time in 2003, as recommended in the Express Scripts Pharmacy Benefit Guide, experienced a net cost trend of 5.9%; and those who implemented two or more tools for the first time in 2003 averaged a net cost trend of -4.6%. Rebates, which were not considered, would have added to the trend reduction. ; Despite increased member responsibility among some plans with low or negative trend, member responsibility remained under 25%, and member satisfaction remained steady at greater than 94, because tramadol.
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