Does your extended medical coverage include vaccines? If you’re unsure, you’re not alone.
Now more than ever, employers need to focus on managing their drug spend effectively and understand their return on investment. What actions can employers take now to ensure that their drug plans remain sustainable for future generations of employees?
For years Cheryl Lundrigan has taken a prescription drug to treat chronic depression. Although she had started out taking Zoloft when first diagnosed, once the drug became available in the less expensive generic format, she switched to Sertraline. But recently she suffered a relapse and the medication didn’t seem to be help any more. Rather than switch to another anti-depressant, Lundrigan’s physician suggested that she go back to the original brand version of the drug to see if it would have a more positive effect than the generic.
With Canadian healthcare costs on the rise, I often suggest to benefits administrators plan design modifications that would cut costs without reducing benefits—for example, a preferred provider network. However, these suggestions are often met with distaste. I hear objections such as, “We can’t ask our employees to go to one pharmacy and not the other.” The discussion historically has ended there—until recently.
Plan sponsors struggling to get their drug plans under control should look at their diabetic population and reiterate the importance of medication adherence.
The topic of specialty drugs still dominates industry discussions, yet very little has changed in terms of the management of these claims. It’s as though specialty drugs have given the industry a vacation from focusing on boring traditional drug plan design in favour of having circular discussions that lead nowhere about wonderful (and expensive) innovations.
In 2011, the amount paid toward drug coverage by Canadian private drug plans reached $7.6 billion, an increase of $1.8 billion over the past five years, according to IMS Brogan’s Private Drug Plan Database. The corresponding increase in cost to plan sponsors has spurred discussions on the sustainability of group insurance plans and the need for a long-term perspective on potential solutions.
owers Watson has partnered with Loblaw Companies Ltd. (Loblaw) as the preferred pharmacy services provider for the firm’s Canadian Rx Coalition, a collaborative network of private sector drug plan sponsors.
The notion that generic drugs represent a new and frightening concept has pretty much been struck from our collective consciousness, yet generic utilization rates in drug plans in Canada have not reached the levels observed in the United States and throughout much of Europe.
The changes and uncertainty in today’s drug benefits landscape are a challenge to everyone. With our aging population, escalating usage rates and blockbuster-priced new drugs around the corner, many business owners are rightly concerned about the sustainability of this essential benefit.