benefits
AS DRUG SPENDING INCREASES, PLAN
MEMBERS CAN RISK LOSING OUT
ON OTHER IMPORTANT BENEFITS.
A study published in 2017 suggested that employer-funded
drug plans in Canada waste approximately $3 billion per year
by covering expensive drugs that have cheaper alternatives.
Employers can minimize waste (unnecessary cost) by covering
drugs that work better or work just as well for less money. This
information needs to be backed by research and recommended
by experts in the field, including doctors, pharmacists and other
healthcare professionals.
There are two main reasons employers are hesitant and often
refuse to change. First, their drug spending has been stable for a
few years and they have not yet reached a tipping point. The sec-ond
point is the nature of change itself. To many employers and
their employees, change means potential disruption and change is
sometimes perceived as a loss – in this case, change could signify
providing less coverage or taking something away.
However, as drug spending increases, plan members can risk
losing out on other important benefits. Change, in this case, is
necessary and this change is for the better. A drug plan centred
around value can improve health outcomes and reduce costs. As a
result, savings across the plan can be re-invested in other benefits,
such as wellness initiatives, mental health benefits and dental care,
among others. Better-managed plans can yield savings for employ-ers
and often lower co-pays for employees.
Too often, drug plans keep employees in the dark. Now more
than ever, patients want to be involved in their personal healthcare
management. With advancements in technology and information
at their fingertips, employees can benefit from a transparent plan
that clearly lays out what is covered, and includes built-in advice as
to drugs that provide the best healthcare value, co-pay options and
quantity limits. In this case, change represents improved employee
communication and engagement, in addition to a positive shift in
the benefits provided.
The private sector has an opportunity to be a leader in drug plan
sustainability, especially at a time when the discussion around uni-versal
pharmacare is pervasive in the public narrative.
Ultimately, it is an opportunity for employers to put the benefit
back into drug plans. HR professionals have a special role to play
when it comes to empowering employees and embracing change –
one that can help all stakeholders benefit from a sustainable drug
plan and getting the best healthcare value. n
Helen Stevenson is the former Assistant Deputy Minister of Health
and Executive Officer who oversaw Ontario’s $4 billion drug
program, where she led prescription drug reform with Bill 102, saving
Ontarians an unprecedented $1.5 billion and helping spark reform
across Canada. She is now the founder of Reformulary Group.
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28 ❚ FEBRUARY 2018 ❚ HR PROFESSIONAL
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