With the cost of health care rising, employers would do well to consider the productivity impacts of illness on their business, participants at Benefits Canada’s Face to Face Drug Plan Management Forum heard last month.
“Billions of dollars are spent,” said Dr. Aslam Anis, a professor at the University of British Columbia’s School of Population and Public Health, during a session at the Dec. 8 event in Toronto. “And if you look at drugs and who pays for drugs, almost $29 billion is spent on prescribed drugs, and about $10 billion of that is paid for by the private sector.”
And according to a Conference Board of Canada study, the estimated direct cost of absenteeism to the Canadian economy in 2012 was almost $17 billion.
“Is there a link between what happens in terms of absenteeism and drug plan management or the cost of your drug plan?” Anis asked.
“The way absenteeism and presenteeism affect what’s going on in our economy is through productivity losses.”
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But most studies into the issue don’t account for productivity costs, said Anis, who downplayed the notion that including them is simply a strategy to make expensive drugs look better.
In Canada, the drug approval process starts with Health Canada, which entertains industry submissions and looks at a product’s efficacy, usually at clinical trials. Next, companies need to provide an economic evaluation of the cost-effectiveness of the drug through the Canadian Agency for Drugs and Technologies in Health (CADTH). “But in looking at the cost-effectiveness, CADTH’s guidelines say indirect costs should not be included in the preliminary baseline analysis. They’re going to presented as a secondary analysis,” said Anis.
“Although it’s an evidenced and informed process, where is the productivity impact covered? It’s not covered,” he said. “It’s totally missing in action.”
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Anis emphasized the need to have an accurate estimate of productivity loss. In his view, Canadian public payers should require “inclusion of productivity impact on cost-effectiveness submissions.” The CADTH process, he continued, needs to recognize the importance of indirect costs. “We need the ministries of health and social welfare to recognize they’re interdependent. We just can’t think of health-care costs as being the purview of the Ministry of Health and unemployment and productivity costs as being the purview of the minister of employment,” he said.
“We need employers to demand the information on the productivity potential.”