Canada’s health-care system isn’t working or sustainable, and the gap between private and publicly funded services deserves our attention, according to Rose Dipchand, regional manager of professional affairs at Pharmasave Atlantic, during Benefits Canada‘s 2019 Halifax Benefits Summit on Sept. 24.
“We’re caught in a tug of war . . . . We’re trying to work with the government and what’s in the best interest of the health-care system’s citizens; we’re spending a lot of money on that gap.”
Investments in access, such as new services or existing services provided by a different provider in a different manner, will lead to improved health outcomes, she said. “A healthy employee is a successful employee is a productive employee.”
In terms of pharmacists, regulators have increased the scope of the services they can provide over the past 10 years. Dipchand highlighted three in particular: prescription extensions, prescription adaptations and therapeutic substitution.
Instead of an employee taking three hours off work to fill a prescription, employers can pay a pharmacist $12 to $15 to complete an assessment and provide renewals, adaptations or substitutions. “Drug spend isn’t increased because you’re already paying for that,” she said. “Instead, three hours of an employee’s time is saved.”
Minor conditions or ailments is another area for prescribing services, noted Dipchand. “Don’t confuse the word minor with not interfering in quality of life. Anybody who’s had a urinary tract infection, athlete’s foot or a cold sore, there’s no way they’re focusing at work — that is, if they even go to work.”
A lot of absenteeism and presenteeism is wrapped up in trying to find timely treatment for these minor conditions, she added. Instead of an emergency or a walk-in clinic, employees can go to a pharmacy and treat — depending on the province — a list of 31 to 33 conditions.
The medication will be paid for anyway, said Dipchand, whether that individual waits in emergency for eight hours, goes to a walk-in clinic or sees a physician. “Pharmacists aren’t increasing your drug cost; we’re giving your employee timely access to health care.”
During the session, she also addressed a potential conflict of interest when it comes to pharmacy services — what’s to prevent pharmacists from writing frivolous prescriptions that will then be filled at their own pharmacies? “The evidence does not bear that,” she said. “Alberta has had this system in place for 10 years and what you see is that about two to 2.6 per cent is the high watermark of all prescriptions written by pharmacists in Alberta.”
If plan sponsors haven’t already done so, Dipchand suggested they can add another layer to their lens when looking at benefits plan designs and cost, noting the pressures on gatekeepers trying to monitor the drug cost bucket.
“The formulary is increasing. That investment needs to be protected and the challenges in our health-care system are not protecting that investment. How do we optimize the health of your team members? There’s an opportunity for you to take a look at a pharmacy services list.”
Read more stories from the 2019 Halifax Benefits Summit.