In light of the federal government developing a national pharmacare program, it’s important it considers the implementation of a national drug pooling program for private payers, says one expert.

“If the government is going to invest in a universal drug program, it needs to have two main objectives,” said Edward Sabat, partner at The Consulting House, in an emailed statement to Benefits Canada.

“The first is to ensure that Canadians who have no access to coverage are protected. The second is to create a national pooling program that will cover high-cost medications, relieve the pressure on plan sponsors and reduce [large amount pooling benefit] charges.”

Read: Back to basics on drug pooling

More than 70 per cent of Canadians rely on employer-sponsored health benefits for private drug coverage, he said, noting private plans cover three times as many new medications and can grant access in half the time compared to government plans. “Canada already lags behind other countries in introducing new medications, with some never reaching our market at all. Employer-sponsored private drug plans are essential to maintaining this access.”

In addition, these life-saving medications can mean the difference between keeping a highly productive employee and, in the worst-case scenario, confronting a life insurance claim, said Sabat.

However, he noted private benefits plans were never intended to handle the financial burden of high-cost, recurring medications and the LAP benefit was designed to cover significant, unforeseen claims like out-of-country injuries and costs represented only three per cent to five per cent of an employer’s extended health premium.

“Today, that figure has ballooned to between 25 per cent and 35 per cent due to the introduction and rising costs of specialty medications and biologics in the market. This surge has created an unsustainable financial burden for employers, prompting some to impose drug maximums to maintain their group benefit plans.”

Read: Quebec drug pooling corp.’s cost increases mean premium hikes for plan sponsors