Shown are the percentages of prescriptions that were written for the lowest-priced drugs for the employees of the RETA Trust, a national association of 55 Catholic organizations that purchases health care for the organizations, and for those of a labor union trust before and after July 2013 (vertical dashed line), when the RETA Trust instituted a reference-pricing program for 1302 outpatient drugs, which were grouped into 78 therapeutic classes. In the first quarter after implementation of reference pricing, the use of the lowest-priced reference drug in each class increased to 69.7% for the RETA Trust and then stabilized, while the use did not change for the union trust.