Prescription drug coverage is the most commonly claimed employee benefit in Canada, making it a key priority for employers and employees alike. However, balancing rising costs with comprehensive coverage can be challenging.
Pharmacare and Prescription Drug Coverage in Canada: What’s on the Horizon?
Canada does not yet have universal prescription drug coverage, leaving millions of Canadians with limited access to essential medications. The Heart and Stroke Foundation reports that around 7.5 million Canadians either lack coverage or have insufficient coverage. As a result, 1 in 4 Canadians report skipping doses, splitting pills, or avoiding refills due to high costs.
Momentum is building for a national Pharmacare plan that could help ease some of the cost burdens currently transferred to private health plans and standardize coverage for essential medications. Bill C-64, which sets the framework for national Pharmacare, has recently passed through the Senate's committee without amendments. It will soon undergo a final vote on the Senate floor, scheduled for October 10, 2024.
Initially, the plan is expected to cover a limited range of drugs, including contraceptives and diabetes medications. Employers should stay informed of these developments to ensure their plans align with future policies, but it’s important to note that the national plan will not eliminate the need for drug coverage under employer-sponsored plans.
Key Strategies to Optimize Benefits and Control Costs
To reduce costs and improve efficiency in your benefits plans, consider these strategies:
- Educate employees about pharmacy options and dispensing fees to help them make informed choices.
- Promote the use of lower-cost generics and make use of available drug plan formularies to manage costs effectively.
- Partner with insurance carriers or pharmacy networks that can monitor medication adherence.
For more guidance on optimizing your benefits plan, reach out to one of our advisors. Below are additional strategies to help you remain competitive in the evolving benefits landscape.
Virtual Pharmacies: A Cost-Effective Solution
Virtual pharmacies offer employees convenient access to medications with benefits like capped markup fees and lower dispensing costs. Services like PocketPills provide higher coinsurance at no additional cost to employers, while Pillway focuses on medication adherence to reduce waste. Though some employees may be hesitant to switch from traditional pharmacies, virtual options can enhance satisfaction and significantly reduce costs. Discuss with your advisor how virtual pharmacies can be incorporated into your plan as a voluntary program without added investment.
Expanding Access with Virtual Healthcare
Virtual healthcare is now an essential component of modern benefits plans, providing employees with access to remote consultations, chronic disease management, and second opinions. These services reduce the strain on in-person healthcare systems and ensure that employees in remote areas receive timely care, improving health outcomes and reducing absenteeism.
Genetic Testing for Prescription Drugs: Pharmacogenetics in Employee Benefits
Pharmacogenetics allows for personalized medication plans based on an individual’s genetic profile, leading to faster recovery and fewer adverse reactions. By reducing the trial-and-error process in prescribing medications, this approach benefits both employees and employers through reduced downtime and medical costs.
The Future of Benefits
As the benefits landscape evolves, employers should explore innovative solutions like virtual pharmacies, virtual healthcare, and pharmacogenetics to control costs while providing high-quality care. By staying informed on public health initiatives such as Pharmacare, employers can offer future-ready benefits that improve employee well-being and manage expenses.
To learn more about implementing these strategies and educating your staff on available resources, contact one of our advisors today!
9 Essentials to Know About Canadian Employee Benefits
With this comprehensive guide, you'll have a better understand of the Canadian benefits system and learn how to keep your Canadian employees productive and happy.
