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Back to basics on stop-loss insurance

When an employee has a health issue requiring expensive treatment, the associated high-cost claims can be significant for their benefits plan sponsor. But it’s impossible to predict when a large claim will arise, so stop-loss insurance, which takes the claim off the employer’s shoulders, is one option to help protect against these unexpected costs. As […]

What will PMPRB drug pricing changes mean for plan sponsors?

Private plan sponsors can expect to see lower drug prices resulting from recent changes to the Patented Medicine Prices Review Board, but there may also be unintended consequences. The reforms, announced Aug. 9 and expected to come into effect July 1, 2020, will update the reference countries Canada uses to compare its prices internationally. They’ll […]

Adoption of B.C. formulary saves private drug plan $13 million: study

As plan sponsors continue to look for ways to control drug plan spending, a new study from the University of British Columbia shows that switching from an open to a closed formulary can save big dollars. The study, published this month in the Canadian Medical Association Journal Open, analyzed what happened when the B.C. Hospital […]

Feds announce final changes to Canadian drug pricing regulations

On Friday, the federal government announced the final amendments to the Patented Medicine Prices Review Board regulations, estimating the reforms will save Canadians about $13 billion in the next decade and lay the foundation for national pharmacare. The amendments, which were put forward by the government in a consultation in May 2017, include an update […]

  • By: Staff
  • August 12, 2019 November 12, 2020
  • 09:45
PEI adds six drugs to formulary at cost of $750,000 a year

Prince Edward Island has added six new drugs to the provincial formulary. People dealing with arthritis, diabetes, chronic obstructive pulmonary disease, lung cancer, heart failure and those receiving radiation therapy will now have help in paying for prescription medications. The promise to help provide better access to medications was made in the 2019-20 provincial budget […]

Could Quebec’s public drug plan work for national pharmacare?

Quebec’s universal pharmacare program offers better drug coverage and quicker approval for new drugs coming to market than the rest of Canada, according to a new study by the Fraser Institute. Looking at drugs approved by Health Canada between 2008 and 2017, the report found Quebec went on to cover 33.4 per cent of them, […]

Drug claims expected to rise in 2019: survey

Plan sponsors can expect to see a three to five per cent increase in prescription drug claims in 2019, according to Buck’s annual Canadian health-care trend survey. However, the survey noted, since insurance providers also add a market inflation factor, the projected increase is actually 10.99 per cent, down from 12.45 per cent in 2018. Based […]

  • By: Staff
  • July 24, 2019 November 12, 2020
  • 10:12
Plan sponsors using generic substitution, co-payments to curb drug plan costs: report

Plan sponsors are increasingly adopting plan design tools to manage their drug plan costs, according to Telus Health’s annual drug trends report. It found private plan drug costs have grown 0.3 per cent per year on average for the past 10 years, made up of an average 2.1 per cent annual decrease in the cost […]

CUSMA’s data protection proposals for biologics could raise costs for private plans: PBO

If the Canada-United States-Mexico trade agreement goes through it could have a significant impact on the cost of private drug plans. Currently on hold until members of Parliament return to Ottawa after the summer break, the agreement as written would extend the data protection term for biologic drugs to 10 years from the current eight. If […]

44% of plan members have had a benefits claim denied: Sanofi

Almost half (44 per cent) of plan members said they’ve had a benefits claim denied, according to the 2019 Sanofi Canada health-care survey. Among this group, 20 per cent have had a dental claim denied, followed by a prescription drug claim (15 per cent) and a claim for a paramedical service (13 per cent). More […]

  • By: Staff
  • June 26, 2019 November 11, 2020
  • 09:03