When it comes to benefits plan management, each case is individual, said Diana Godfrey, senior vice-president of human resources and corporate at Fidelity Canada, during a session at Benefits Canada’s 2020 Employers Cancer Care Summit on Mar. 3. “If employers think they have a program or policy that covers every situation, they may be mistaken.” […]
Taking a look at private drug plans in 2020, a number of trends are converging: spending on specialty drugs is continuing its upward trajectory, advancements in a number of lifechanging therapies are in the pipeline and policy developments are coming at both the federal and provincial levels. In the face of this potential storm, plan […]
Since the point of an editorial is to create a discussion on the trends and issues affecting our industry, I was glad to see my latest — in the January/February issue — sparked a good debate. The print edition of Benefits Canada doesn’t have a Letters to the Editor section, so I’m compiling all the […]
How does a plan sponsor solve a problem like a massive drug claim? One solution embraced by the Canadian market is drug pooling, which goes back to the heart of pure insurance. Pooling risk to mitigate certain health-care costs is a long-standing practice in Canadian employee benefits. A benefits plan pays a pre-determined pool charge […]
In employee benefits plans, maximums and caps on prescription drug dispensing fees are common cost management features. These features are designed to nudge plan members to purchase prescription drugs at pharmacies with lower dispensing fees, lowering their out-of-pocket costs, as well as potentially reducing plan costs for employers. For example, where a drug plan has a $5 dispensing […]
On Dec. 3, the 2019 Face to Face Drug Plan Management Forum featured sessions on rare disease, the pharmaceutical industry’s point of view, legal obligations in drug plan management and a deeper dive into drug programs. Capping coverage for plan members with rare diseases poses an ethical dilemma While high-cost specialty medications represent about 30 […]
While high-cost specialty medications represent about 30 per cent of drug costs, the total budget impact of rare disease drugs is less than two per cent, said Brad McCaw, associate director of market access at Alexion Pharmaceuticals Canada. Within the high-cost specialty market’s top 20 drugs, only one is designated for rare disease, he said […]
Pharmaceutical companies and private payers can interact in different ways to ensure the right drugs are getting to the right patients, according to Kathy Sotirakos, senior manager of market access and private insurance at Amgen. Real world evidence will help inform better decision-making from a predictability and outcomes perspective, she said during a panel at […]
As the landscape of Canadian drug plan management continues to evolve, several programs are being implemented by insurers and pharmacy benefits managers to help plan sponsors manage costs. Speaking on a panel at Benefits Canada’s 2019 Face to Face Drug Plan Management Forum on Dec. 3 in Toronto, Ned Pojskic, leader of pharmacy and health provider […]
Quebec employers can expect to face significant increases to their drug pooling premiums in 2020. The Quebec Drug Insurance Pooling Corp., which sets the annual pooling parameters for private drug plans in the province, has increased the cost that plan sponsors with Quebec employees must pay per plan member. Plan sponsors pay different rates for members with and […]