The results of new Benefits Canada research released at the Pharmacy Solutions in Drug Plan Management Forum in Mississauga, Ont. on Oct. 4 are shedding light on what plan sponsors think about introducing pharmacy services to employee benefit plans.
While a large number of plan sponsors signalled their interest in exploring this option, the online survey of 106 Canadian health benefit plan decision-makers shows a gap still exists when it comes to knowing exactly which types of services pharmacists can provide.
Respondents estimated 38 per cent of their employees had a chronic condition, such as high blood pressure, mental-health issues or diabetes, via information gathered primarily through personal observations, interactions with plan members and claims data. The average size of the organizations surveyed was 1,500 employees.
Nevertheless, only 16 per cent of respondents said they knew the proportion of employees who adhere to their medications to treat chronic conditions.
Speaking on a panel delving into the survey’s findings, Anne-Marie Smith, practice lead for drug management solutions at Medavie Blue Cross, said employers want some assurance that members are adhering to their medications.
The costs associated non-compliance can have significant consequences as it may result in prescribing more medications, poor employee health outcomes, faster disease progression and increased health-care costs in the future due to disabilities and absenteeism.
“At the end of the day, I think patients need support and a network in place to improve compliance and adherence and who better positioned to provide that than pharmacists?” said Smith.
Jonathan Tafler, director of payer programs at Shoppers Drug Mart and Loblaw, noted the reasons why people aren’t adhering to their medication are simple: they often forget, are dealing with side-effects or are waiting for a doctor.
However, intervention by a pharmacist often leads patients to refill their prescriptions sooner, with statistics showing that almost all of those who receive a call will pick up their medication, said Tafler.
In terms of knowing what types of services pharmacists can provide, three-quarters of survey participants said they know they can give flu shots. Another 62 per cent were aware pharmacists can provide medication reviews.
However, only a third of respondents answered yes when asked whether pharmacists could do renewals and screenings and prescribe for common ailments.
As Dennis Darby, chief executive officer of the Ontario Pharmacists Association, told the conference, most plan benefit sponsors don’t know that “pharmacists in most provinces can renew prescriptions for chronic medications, without having to have the person go back to the doctor.”
If screenings, prescription renewals and prescribing for common ailments are also available at the pharmacy, employers will also benefit, according to Darby. “Those are keeping your employees at work,” he said.
Plan sponsors surveyed by Benefits Canada did indicate a high level of interest in pharmacist services — such as medication reviews, therapeutic substitutions and prescriptions for common ailments — as a reimbursable benefit under employee benefits plans and as an eligible expense in health spending accounts.
But at the moment, plan sponsors say the biggest barriers to including pharmacists’ services in benefit plans is the added cost.
It’s good news that employers “recognize the value pharmacists can bring to the table today, in terms of medication and [being] chronic disease managers, versus just medication dispensers as in the past,” said Smith. But at the end of the day, she said employers, in consultation with their advisors and insurers, will determine what they can afford to pay the additional cost of pharmacy services.
As Adam Hanson, manager of group strategic relationships at the Great-West Life Assurance Co., noted, cost is a very real barrier and plan sponsors want to see “provable” programs, with reporting up front as well as after the fact.
Aldo Alexis, director of compensation and benefits with the University Health Network, noted the need for education for both individuals and plan sponsors to ensure a clear understanding of what services are available at pharmacies. And for plan sponsors, he added, they need to understand the usefulness of those services.
Read more stories from the Pharmacy Solutions in Drug Plan Management Forum