In light of the federal government developing a national pharmacare program, it’s important it considers the implementation of a national drug pooling program for private payers, says one expert. “If the government is going to invest in a universal drug program, it needs to have two main objectives,” said Edward Sabat, partner at The Consulting […]
The World Health Organization defines a rare disease as having a prevalence of 65 or less per 100,000 individuals. It recognizes some 5,500 rare diseases, the majority being of genetic origin and often life-threatening. Medical research has yielded significant drug development for the treatment of rare diseases, increasing life expectancy and improving quality of life. However, […]
A recent survey by Innovative Medicines Canada found there are growing listing delays among Canada’s private drug plans, said Joe Farago, the organization’s executive director of private payers and investment, during a session at Benefits Canada’s 2023 Face to Face Drug Plan Management Forum in December. The survey noted private payer review times can take […]
A recent report by the Patented Medicine Prices Review Board shows increased growth for private drug plan costs but promising pharmaceutical innovation, says Joe Farago, executive director of private payers and investment at Innovative Medicines Canada. The report also found the number of new medicines launched in Canada was higher than the median for Organisation for […]
The growth of gene and cell therapies are raising significant questions among private payers about who bears the responsibility for the costs of these treatments, says Tim Clarke, president at TC Health Consulting Inc. “One issue is whether this is going to be paid for by public health or if it’s an employer health issue. […]
With cost of private drug plan claims rising about 5.5 per cent each year, pooling is one solution that could be beneficial for benefits plan sponsors. “Theoretically, if these claims could be shared across a broader group, such as the complete private insurance industry, plan costs could be less volatile for individual plan sponsors,” said […]
There’s no question that Canadians value their private health benefits, even with pharmacare discussions back on the table. In a recent Abacus Data study, 78 per cent of respondents said they feel group benefits plans increase the availability and affordability of health services in Canada, as opposed to undermining universal health coverage. Furthermore, 92 per […]
A British Columbia labour arbitration decision is providing insight on how a block level implementation of a benefits provider’s drug cost-control program violated a collective agreement in a unionized workplace. The Douglas College Faculty Association grieved the implementation of Manulife’s DrugWatch program contravened their collective agreement, which ensured “there will be no change to the […]
Changes to Quebec’s policy on the use of biosimilars in its public drug plan could result in savings for private benefits plans, says one expert. On April 13, 2022, the Régie de l’assurance maladie du Québec will delist certain biologic drugs from its formulary, requiring patients covered by the plan to switch to a biosimilar […]
The Canadian Drug Insurance Pooling Corp.’s high-cost drug framework provided coverage to almost 28,000 Canadians and their families where drug costs exceeded $10,000 annually in 2020. According to its results, the CDIPC estimated that its member insurance companies reimbursed claims associated with 54 new high-cost drugs including those for rare diseases. As well, based on past experience, […]