Drug costs are the #1 health plan cost

Employee Benefits Tips and Tricks: Canada Plan Management - some considerations.
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Transcript

Hi, Alan Friesen here certified Employee Benefit Specialist. I'm here with another tip or suggestion to help you get the best value out of your employee benefit program. Now this tip is just about drug coverage. drug coverage is probably the single largest component of claims on your health plan. Well, it is for sure on your health plan. And a lot of times, especially the new medications coming out biologics, etc, the costs are only going to get higher.

So what do you do about that? Or should you do something about that? Now the matter of whether you do something about it or not, is really your call you as the plan sponsor have to decide what's important. I'll give you a good example of sometimes clients aren't that concerned about it. I had a client recently where they had about 50 employees and about 80 people covered in total. So if you add in the spouses, you add in the children, there's about 80 people covered their drugs.

Was $100,000. Now in looking at the data, one person was like $34,000 of those claim was for one person. Overall the drug spend was reasonable in terms of what their past drug spend was. And the rates were actually reducing. So the client was fine with everything as it is. They weren't concerned about this one person using that degree of drugs.

And their thought is, well, this year, it's Sally who needs that support next year, perhaps it's Gavin who needs that support, and maybe next year, it's me. So they didn't really want to manage that program. They were happy with how it is. But if you are concerned about the cost of drugs, because the cost of drugs will yield to greater claims and greater claims will cost more rates. That's that's the connection that's going to happen. There are a myriad of tools that you could use to help control those changes in terms of the of the dispensing fees, the caps that way, changes in terms of least cost alternative changes in terms of shifting some of the cost to other programs when appropriate mail order type pharmacy sort of programs.

So there are many different solutions that are available, including caps maximums on drug programs. So there's a lot of solutions available if in fact you want to manage those costs to keep your rates affordable. I can certainly help you with that. If you'd like more information, want to discuss it further gladly help give me a call or contact me My contact information is on the screen. And thanks, keep well

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