A typical patient’s journey takes plan members from the doctor to the pharmacy for medication and then leaves them on their own.
But employees’ lives aren’t static, with factors like age, mental and physical health, stress and activity level having the potential to impact how effectively those medications work, said Frederic Simard, co-founder and chief of product and strategy at MedHelper, during Benefits Canada’s 2022 Tech Insights conference in mid-April.
“With all the things in life that can change, it should be no surprise to anyone that serious medication-related issues will develop,” he said, citing adherence, dose and frequency, medication change, medication addition or de-prescription and side-effects as the five most common areas for medication issues, four of which require clinical intervention to address.
“These serious medication issues naturally occur in more than half of people, . . . they typically get worse over time and they mostly go unaddressed until they’re bad enough to seek treatment.”
These risks could impact a significant percentage of employees. In an average Canadian workforce of 1,000 employees, roughly 250 would be heavy medication users with two or more chronic illnesses, three or more medications daily and nine or more draw claims annually. An additional 19 per cent are classed as moderate users, who have at least one chronic condition. Overall, 61 per cent of employees had at least one prescription in 2021.
“But nobody, across all categories, gets any proactive support, no follow up to ensure that their medications overall are working well. They’re on their own,” said Simard. Heavy medication users in particular, he added, are dealing with conditions that can lead to absenteeism and disability, which can be five-times more costly than medications.
But there’s good news: a proactive and thorough assessment of medication can avoid those medication issues. To do that at scale, employees need to have on-demand access to clinical pharmacists and pre-scheduled follow-up consultations every six months, supported by digital technologies to ensure efficient interactions and an optimal experience.
Clinical pharmacists perform these individual assessments and followups in hospital settings, where Simard said it’s very effective. But he noted they’re not accessible in the system and the services are specialized and time-consuming.
That’s where MedHelper comes in. The company, which was born out of personal experience, specializes in proactive, post-diagnostic medication support. The mobile app allows employees to receive an individual assessment from a clinical pharmacist, who defines and documents any clinical interventions and follows up on the consultation.
MedHelper pharmacists are able to support employees with medication doses or frequency adjustments, medication changes, adherence and side-effect management, addition and de-prescribing, lifestyle coaching, education and information. Simard said the experience doesn’t replace the need for doctors or dispensing pharmacies: the service’s pharmacists also refer some services to the employee’s health-care provider.
Through the app, employees have access to their medication list, customized reminders and alarms and medication management tools shared by their pharmacist. They can also share their data with their health-care professional and document any side-effects.
MedHelper’s pharmacists are also trained to spot opportunities for generic or biosimilar substitutions to reduce the cost to plan sponsors’ and employees’ out-of-pocket expenses.
Pre-scheduling follow-ups draws on common, proactive practices in dentistry, where regular cleaning appointments can save employees from costly dental care down the road, said Simard. “In light of all the complexity surrounding drugs and all of the factors that change in our lives, the same recurring approach is shown to be very effective with medications.”
Of all the cases MedHelper has worked on over the past few years, 40 per cent made a change to their medications linked directly to the top five medication issues. “That’s four out of 10 participants in our program with a clear, black-and-white avoided health program,” he said. “Providing greater access to clinical pharmacists is a game-changer.”
Read more coverage from the 2022 Tech Insights conference.