It goes without saying that most employers would like to have a healthy workforce—both for the sake of employees as well as for the benefit of their bottom line. Hewitt’s 2007 Disability Absence Index survey valued time lost annually due to disability absence at more than $3.5 million for a population of 1,000 employees. That figure doesn’t include the cost of drug coverage, which is already significant and likely to increase as employees work past age 65 and retirees, if covered, live longer.

Despite their intentions, however, many employers may not be adopting an approach that is designed to encourage organizational health. Take, for example, the manner in which some employers are dealing—or, more accurately, not dealing—with cancer in the workplace.

One in three Canadians is expected to develop cancer at some point in their lives. The Canadian Cancer Society estimates there were 159,900 new cases of cancer in Canada in 2007, 30% of those in people between the prime working ages of 20 and 59.

Lack of awareness

Last month, Hewitt conducted a Rapid Response survey on cancer drug coverage, seeking to determine how proactive organizations were being in helping employees and their families to battle cancer. The results indicate that many employers not only don’t know what action to take with respect to cancer drug coverage, they may not be aware of all the issues.

• Three-quarters of the 203 respondents had not reviewed their benefit plan recently in light of new cancer drugs.

• When asked whether their plan covered treatments including oral medications, IV medications administered in hospital, and drug costs and administration fees of medications administered in a privation clinic, between a quarter and a third of respondents, depending on the type of treatment, had no idea whether their plan provided coverage.

• More than half (58%) of respondents indicated their plans cover oral cancer medications. However, it wasn’t clear whether the decision to do so was a conscious one on the part of employers, or merely the result of an open formulary that automatically included this coverage.

• Approximately 10% of respondents had made changes to their plan design to control costs. These changes included adding a drug formulary, excluding some drugs, adding a drug benefit maximum, and introducing or increasing an out-of-pocket maximum.

• If some provinces began having IV medications dispensed and administered in hospital and paid for by the patient, 30% of respondents would cover the cost, but 51% don’t know what they’d do.

• Ninety-two percent of respondents had not communicated with their employees about cancer drug coverage.

Leveling the playing field

Employers clearly seem uncertain of how best to proceed when it comes to cancer in the workplace. They don’t know what is covered, what should be covered, and what to tell employees. And ignorance about cancer drug coverage is one area where what employers don’t know can hurt them.

Coverage of various cancer drugs under the public healthcare system is determined provincially, resulting in a patchwork of policies across the country. This means that employers with workers in more than one province may find that their employees are receiving uneven treatment. Those in B.C., the province with the most generous provincial drug plan funding for cancer drugs according to the Cancer Advocacy Coalition of Canada, may well be covered for certain drugs that aren’t available under the plans of other provinces.

The result is that an employer that wants to ensure that its drug coverage is national in scope may find itself footing the bill in some provinces to pick up the shortfall.

Time to take action

Beyond equalizing coverage between the “haves” and “have-nots”, employers must determine whether they will cover the cost of new drugs, while waiting for the provinces to decide whether to pay for them. New medications like Gleevec for leukemia and Herceptin for breast cancer can cost between $25,000 and $50,000 a year per employee.

The decision of whether or not to pay for new drugs depends on the company’s big picture view of its role in helping workers battle cancer and return to work as soon as possible. With that reference point firmly fixed, an employer should then find out what cancer drug coverage is provided provincially, whether there are any discrepancies amongst provinces where it has workers, and exactly what is covered under its insurance contract. If there are outstanding expenses, the employer must weigh the cost against its philosophy, budget and demographics.

Once they determine exactly what is covered, employers need to talk about their approach to cancer. Organizations should consider sponsoring special sessions for managers so they understand how best to support team members who are either afflicted themselves or who have family members with cancer.

And, of course, employers need to talk to employees about their cancer care coverage and explain why they have taken the approach they have. It’s also important to work with employees, cancer support organizations and EAP providers so that workers understand measures that can be taken to help deal with and reduce the risk of cancer.

For the moment at least, cancer is here to stay and odds are that all workplaces will have at least one employee, if not many more, that are affected by this disease. It’s time for employers to address cancer head on and make a plan to help employees and their families in the fight against it.

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