April Scott-Clarke
Suzanne Lepage, private health plan strategist from Kitchener, Ont. presented a thought provoking and education session at the Canadian Health and Wellness Innovations Conference, hosted by the International Foundation of Employee Benefits Plans in Las Vegas.
Here are some of the key facts and figures from her presentation. For a more in-depth story on this topic, read The truth about drug reform
- Few provinces are doing much to reduce costs for private plans. Most of the reforms are, at this point in time, only benefitting public plans.
- The new generic drug pricing may not make much of an impact on plans. In Ontario, 75% of total drug dollars paid are spent on brand-name drugs. In British Columbia, that number only falls to 72%. Most plans are not using large amount of generics.
- Only 20% to 30% of Canadians over the age of 65 have access to a private healthcare plan.
- Plan sponsors should consider case management strategies for high-claim drug costs. This is not a popular cost-containment strategy in Canada currently but is popular in the U.S.
- New drugs are talking longer to get listed on public formularies—sometimes up to 316 days—and therefore only received by the private plans or those with the ability to pay cash for treatment