Calls to action abound at drug plan management conference

Panellists at Benefits Canada’s Face-to-Face Drug Plan Management conference earlier this week called for rational, effective cost-cutting measures to ensure benefits plan sustainability.

There was a distinct sense of urgency in the packed conference room in Toronto. “Is the pain big enough that we’re going to see some meaningful [plan] design change?” asked one attendee.

“We are at that point of change,” said panellist Lisa Callaghan, assistant vice-president, product, group benefits, with Manulife. “If all stakeholders [just] continue to talk, employers can’t wait. And those decisions may or may not be in the best health interest of employees.”

So it was refreshing to hear that firms such as Pitney Bowes are taking action. John Law, director of total rewards and global director of benefits at Pitney Bowes, told the audience about the revamp of its carefully choreographed benefits plan that launched three months ago—culminating in an astonishing 98.3% enrollment rate.

“We needed to integrate benefits more effectively in our total value proposition,” said Laws, who regaled attendees with the challenges of selling the idea to skeptical staff.

Though a carefully orchestrated campaign, Law says Pitney Bowes reduced the complexity of the plan, introduced cost-saving measures such as a managed formulary, brought naysayers onside by involving them in plan design communication—and got buy-in from all levels of the organization.

It was an inspiring tale at a time when plan sponsors are grappling with high-cost specialty, orphan (drugs that prevent or treat rare diseases) and biologic drugs, employee non-compliance issues around medications and a lack of case management. This was echoed in Benefits Canada’s newly released Canadian plan sponsor survey results, which reveal their views on benefits plan sustainability and drug costs in the future.

But while many sponsors came with questions, answers abounded. Panellists talked about the variety of strategies to mitigate costs of challenges of pharmacogenetics testing and the entry of new specialty and biologic drugs—managed formularies, biosimilar adoption, use of management strategies, clinical management—and the pitfalls of stop-loss pooling.

The morning concluded with a call to arms. “You can’t just keep having tails wagging dogs,” said health policy lawyer Louise Binder. “You’ve got to get this right.”

 Look for full coverage of the Face to Face Drug Plan Management conference later this month.