British Columbia’s plan to eliminate or reduce prescription drug deductibles for low-income earners could also lead to lower drug costs for plan sponsors in the province.
While Nick Gubbay, a principal and group benefits consultant at Eckler Ltd. in Vancouver, says the impact is likely to be most material for group plans providing benefits to B.C. retirees on lower incomes, he adds it’s imperative for employers to ensure their benefits plans are aligned with the provincial program. “Irrespective of these changes, plan sponsors should ensure that they require their members in British Columbia to be registered with the provincial PharmaCare program, and that their insurance carriers have appropriate mechanisms in place to support integration with this and other aspects of the provincial program,” he says.
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The provincial government announced Friday it’s investing $105 million into Fair PharmaCare over the next three years with the aim to eliminate or reduce deductibles for 240,000 families with net incomes between $15,000 and $30,000 from Jan. 1, 2019.
Co-payments will be eliminated for families with a member over the age of 79 and with net incomes lower than $13,750. Families with net incomes under $45,000 will see co-payments reduced.
Prior to these changes, families paid a deductible of $300 once their household net income reached $15,000 and a deductible of $900 once it reached $30,000.
According to analysis by the B.C. Ministry of Health, increases in deductibles lead to lower drug spending, which they suggest is an issue of affordability. The ministry’s analysis also found families with incomes under $45,000 are less likely to have prescriptions filled, or to have to make tradeoffs with other expenses.
“We know that in families earning under $30,000 in net income, needed prescriptions go unfilled too often because PharmaCare deductibles are too high,” said B.C.’s Minister of Health Adrian Dix, in a news release. “The step we’re taking today is a significant one, as deductibles have not been changed in 15 years.”
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It’s good news for households in the province, especially if they don’t have coverage through their employer, says Gubbay. And while he notes it’s not clear whether the recently announced deal between the pan-Canadian Pharmaceutical Alliance and the Canadian Generic Pharmaceutical Association for reduced prices on a number of generic drugs was related to the timing of B.C.’s announcement, Gubbay says it’s another example of a provincial government making improvements in the absence of a national pharmacare plan.