To get control of drug plan management and the escalating costs, plan sponsors along with healthcare industry stakeholders need to work together. And the government has to get more involved too.

No, it’s not a revolutionary idea, but it’s something that must happen if long-term solutions are going to be developed-and be successful. The desire for teamwork arose in discussions at every one of the eight roundtables hosted by Pharmacy Post and BENEFITS CANADA on June 15 in Mississauga, Ont. as part of the annual Solutions in Drug Plan Management conference.

Geoff Johnson, manager, key account manager, trade and pharmacy relations at Wyeth Pharmaceuticals in Markham, Ont., acknowledged the prevailing attitude: “Government plans and healthcare tend to work in silos looking at their own bottom lines versus taking into account the broader impact of positive health outcomes on the overall healthcare system.” That attitude needs to change as Guy Pouliotte, executive director at the Public Service Health Care Plan in Gatineau, Quebec, pointed out. “The only common thread we have is cost, and as long as that is the common thread we’re not going to make progress,” he said.

To move forward, the problems in drug plan management need to be approached more holistically. “What we’re looking at is employee patient care through the workplace and through the community,” said Paul Foley, director of private health plans for Shoppers Drug Mart/Pharmaprix in Toronto. “We all have a role in getting there. As employers and insurers, we’re all at different stages and we’re all recognizing we need to bring government to the table more often.” Aubrey Browne, national vice-president pharmacy services, Shoppers Drug Mart, believes urgency and a more resolute position are needed when dealing with the government. “One day employers will wake up and see they are sinking,” he said. “They have to say to government that they can’t afford the off-loads.”

Imma Monardo, manager, benefits and retirement arrangements, Cara Operations in Mississauga, Ont., thinks it is time to figure out how the stakeholders can work together to provide improved service now and in the future, not to invent new solutions. “We don’t have to reinvent the wheel,” she said, adding that what needs to be asked is how the players can better deliver, administer and manage medications and health services for employees. “You need people that are already there-frontline pharmacists are a prime example-to be partners in all of this and they are not necessarily utilized like they should be.”

“A lot of it depends on how engaged the employer is in their benefits and the health of their employees,” said Jeff May, vice-president, pharmacy, professional affairs, Shoppers Drug Mart. “If the employer is actively engaged and there are support programs in the workplace” then conversations about the employee’s health management are more productive.

One crucial factor-return on investment(ROI)-is needed to convince employers to provide health services, like wellness programs or health workshops with pharmacists. “We’ve got a senior team that believes in doing the right things for their employees, but can’t have an outcome with no ROI. [We must] have ROI,” said Megan Broderick, HR services manager, Pepsi Bottling Co. in Mississauga, Ont. “It may not necessarily have to happen in year one-our senior team would probably accept that-but in year two, if there’s no ROI, it’s probably not going to happen. We would only be able to sell it if quantitative results showed that there was a return.”

“I still see there is desire to [have a benefits and drug plan],” said Steve Bradie, senior vice-president and chief operating officer, Green Shield Canada, in Windsor, Ont. But individually tackling the numerous problems in providing these services is no longer an option. Recognizing the need to work together is an essential step, but only the first. The next step is to come together to coordinate synergistic solutions. And as Bradie noted: “It’s up to us to figure [out] how.”


By Nancy Kuyumcu

After salaries, employee benefits are the most costly expense to an organization. So it makes business sense for employers to understand drug plan design and ensure they are getting the most bang for their buck. The Solutions in Drug Plan Management roundtable discussions brought together healthcare stakeholders to address this and other issues. Here are two points that came out of the roundtable “Optimal Design/Seeking to Understand Cost Drivers”:

Employees should take charge of their own health. One of the challenges facing employers is getting employees to accept responsibility for their own health. “The onus is on the employee,” says Gavin Buhr, chairman, Member Benefit Trust, Vancouver B.C. “We have 6,000 members on our benefit plan. Most of them rarely look at information we send to them regarding their benefits. So we have to keep the communication we mail out very simple and straightforward.”

Medication adherence affects productivity. Both employees and employers are responsible, to some extent, for the health of a workforce, says Wayne Marigold, manager, pharmacy operations, Centre for Addiction and Mental Health in Toronto. “Employees are responsible for doing their job and ensuring they’re well enough to show up for work. Employers should care, because if employees are not there, it affects productivity,” says Marigold.

Leigh Doyle is assistant editor of BENEFITS CANADA.