Bell Aliant keeps prescription drug costs top of mind for its employees—and their doctors.
Bell Aliant Regional Communications, the regional telecommunications company for Atlantic Canada and rural Ontario and Quebec, began to implement its flexible benefits plan, flexconnect, in 2003. Aliant was formed out of the four Atlantic telephone companies, each of which had its own benefits plan. But the formation of the new company called for the creation of a revised benefits plan. “Four-to-one alignment of our policies and programs kept us busy for about five years, bringing everything together,” says Hugh Paton, senior benefits consultant with Aliant.
This flex plan has helped Aliant to keep its health and dental claim costs low; their annual increases have been about 7% or 8% in the last three years. “All the employees in a common plan now, for the third year in a row, are understanding that they each pay a portion of the charge at the pharmacy counter and a portion of the benefits cost out of their paycheques by payroll deduction,” says Paton. “That, together with our employee communication, has had an impact in helping everybody [become] a wiser consumer.”
The Doctor Is In…
But Aliant is not only targeting employees. “Getting doctors to write prescriptions for the most cost-effective drugs can be quite challenging because they are often marketed to and visited by individuals who want them to prescribe the most expensive drugs,” he says. And, he adds, research shows that the most expensive drugs aren’t always necessarily the best.
Aliant, in collaboration with a few other Atlantic employers and one provincial government drug plan, is involved in a pilot program called Prescribe the Solution, both in Nova Scotia and in Prince Edward Island. Plan sponsor group representatives visit doctors in their offices, providing materials such as easyto- read one-page summaries of the costs of commonly prescribed drugs and research studies to support generic or lower-cost brand efficacy. “[The doctors] enjoy hearing an opposite point of view to the [one] presented to them by the representatives of brand manufacturing companies,” says Paton. Plan sponsor reps also leave a 30-day supply card of a generic drug and inform the doctors that they can give this to their patients who are in Aliant’s drug benefits plan. “The patient presents [the card] to the pharmacy, [and] the pharmacy sends the claim to us for reimbursement.” Paton says Aliant will be evaluating the impact of the program at some point next year.
Spreading the Wealth
In New Brunswick, Aliant is working in collaboration with other employers and insurer Medavie Blue Cross to communicate drug prices to doctors in an easy-tounderstand format through the Partnership With Physicians program. Doctors are given a laminated two-sided chart of commonly prescribed medications— colour-coded and priced—for a number of common ailments. “The expensive drugs are highlighted in red, the midrange ones in yellow and the least expensive in green,” he says. The quick reference tool allows doctors to “educate themselves about the price of drugs and different cost alternatives that they may have forgotten about because they just aren’t top of mind. [The doctors] seem to indicate to us [that] they don’t normally have that information in front of them, so they can’t change their behaviours.”
Of course, employees require that same information, too. Employees need to go into the doctor’s office with the same mindset, says Paton. “We have to educate employees and retirees because we’re hearing from some of the doctors that they’re willing to change, but our employees are still asking for the little blue pill or ‘the one that my friend has’ because they want the most expensive [drug]—because it’s got to be better.”
While Paton hasn’t heard of any other Canadian pilot programs of this nature, there are some in the U.S. “You hear in the States about consumer-driven health plans, CD HPs. This is the same thing. You give consumers a big enough incentive to investigate for themselves. It can be by plan design or education,” he says. “But a financial incentive through plan design is the right way. When people’s dollars are impacted, then they’re interested in changing their behaviours.”
Brooke Smith is Associate Editor of Benefits Canada.
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© Copyright 2008 Rogers Publishing Ltd. This article first appeared in the December 2008 edition of BENEFITS CANADA magazine.