The federal government is getting out of the medicinal marijuana business and is looking to move the prescribing responsibilities to doctors and the manufacturing to the private sector. Right now, the impact on plan sponsors is moot, but that could change.
Chronic illnesses such as depression, cancer, heart disease, stroke and diabetes cost organizations big dollars in declining productivity, as well as soaring drug costs and claims for short- and long-term disability. It’s a problem many employers are addressing with an “ounce of prevention” approach, seeking to manage the impact of chronic diseases by improving employee health and wellness.
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.