“New medicines can mean a world of difference—the difference between remaining in hospital, or being allowed to go home, between going to work everyday and being productive, or having to go on disability,” Wendy Zatylny, vice-president stakeholders and partnerships with Rx&D said as she opened the 2008 Drug Innovations Forum, held recently in Toronto. “Finding ways to ensure our healthcare system is sustainable and affordable is more important than ever.”

The third annual conference, hosted by Working Well magazine, gave plan sponsors a glimpse of what’s new on the drug and therapies landscape and a chance to listen to industry experts as to why new or alternative treatments should included under public private healthcare plans.

Zatylny cited the Pitney Bowes diabetes program as an example of how the use of innovative pharmaceuticals can result in improved outcomes and lower overall health costs—including drug costs.

What Pitney Bowes did was reduce its tier 1 formulary status drugs (mostly brand name) to a co-payment rate of 10% from the previous rate of 25% to 50%.

By expanding coverage and access to treatment, patient adherence to medications increased, the average total pharmacy costs decreased by 7% and emergency department visits decreased by 26%. Overall, healthcare costs per plan participant with diabetes increased by 6%, but there was a significant slowdown in the rate of increase in net per-plan-participant costs. In 2003, Pitney Bowes paid $4,000 for each participant, compared to the industry standard of $6,500.

“Instead of restricting the range of drugs available, as so many cost-driven policies do today, this firm recognized that the solution to stemming the rising costs of diabetic care for their employees was not to limit available drugs but to increase choice and encourage employees to use the most appropriate drug treatment for them,” explains Zatylny. “Greater access to appropriate medications led to healthier employees. And, healthier employees don’t need to spend as much overall on medical care.”

This example was just one of many examples given by presenters during the day of how costs can be reduced if both public and private plans become more willing to incur increased upfront costs in return for long-term savings.

Other presenters of the day were Dr. Chris Cobourn, medical director and surgeon with The Surgical Weight Loss Centre; Dr. Peter Selby, clinical director, additions programs, with the Centre for Addition and Mental Health; Anitasha Puodziunas, senior oncology, medical affairs liason with BMS; and Dr. Gabor Kandel from St. Michael’s Hospital and the University of Toronto.

Coburn spoke about obesity in the workplace and Laparoscopic Adjustable Gastric Band (LAP-BAND) surgery as an alternative to gastric bypass surgery. The surgery, which is less invasive than a gastric bypass but is similar in cost, isn’t currently covered under most healthcare plans.

Selby’s presentation covered innovations in smoking cessation programs and how employers can avoid costs related to chronic diseases and lost productivity by supporting these evidence-based strategies.

Puodziunas presented the benefits of targeted cancer therapies using Erbitux (cetuximab), a drug used to treat patients diagnosed with colorectal cancer, as an example.

Kandel spoke about the direct and indirect costs of gastro-esophageal reflux disease (GERD) if it’s not properly managed, advocating that there should be lighter or no restrictions on proton pump inhibitors (PPIs) which would improve patient choice and ultimately improve disease management and costs.

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