The value of a drug benefit
Prescription medicines—from familiar antibiotics and pain relievers to new specialty drugs—can have a profound effect on our quality of life. So it’s no surprise that employees value their drug benefit more than other benefits—so much so, they’d rather pay more than see coverage reduced. What might be surprising is how many employees on maintenance medication don’t take their medicine as prescribed—34% of those with high blood pressure and 40% of those with diabetes, for example. This can lead to unnecessary complications, such as heart attack or stroke. And this can drive up costs, through increased:
- absenteeism and presenteeism
- drug spend, including new prescriptions for high cost specialty drugs
- hospitalization
- disability
Your drug plan is an investment. It’s one of the ways you attract and retain high quality employees. But maintaining an affordable and sustainable plan is an ever-increasing challenge.
The opportunity today is to design a plan that offers the right level of support and the right cost management features. So your plan is sustainable. Empire Life can provide a plan that helps you better manage costs while providing employees the coverage they value. With more and more high cost specialty drugs coming to market, it’s a great time to make sure your drug plan is in good shape.
Flexibility and choice
We make it easy to design a plan that reflects your benefit goals and budget.
Our drug plan has lots of flexibility, so you can choose the design, cost management features, and employee cost sharing levels that are right for your business. You can customize your coinsurance, deductible, dispensing fee, and maximums. You can also add mandatory generic substitution, preferred providers, and more.
Our new Actively Managed Drug Solutions, powered by Express Scripts Canada, offers robust cost management and a specific focus on employees who take maintenance and/or specialty medication*. That’s important today, since chronic disease is on the rise in Canada and more medication is being charged to drug benefit plans. The Express Scripts Canada team provides employees taking maintenance or specialty drugs with a highly personalized service, so they:
- better understand their health condition
- are more likely to take their medication as prescribed— and suffer fewer unnecessary and costly complications
- are alerted to the existence of lower cost, clinically appropriate alternative drugs so they can make more cost-effective choices
Medication is delivered in unmarked packaging, directly to employees address of choice. This makes it easier to stay on track. Employees also receive longer day-supplies of drugs, which translates into fewer dispensing fees and better cost management. And because Express Scripts Canada pharmacists see the full picture, managing all employees’ maintenance and specialty drugs, they’re better able to help them stay on track.
*Not available in the province of Quebec.
Key features and benefits
- Well thought-through coverage, with a choice of coinsurance options, deductibles, and maximums, allows you to design a plan that's right for you.
- Competitive coverage to ensure employees' key needs are met.
- Cost management options to help make it easier for you to control your drug expenses.
- Product listing agreements (like Remicade through Express Scripts Canada), to control the cost of specific drugs
- Pay-direct drug cards are provided at no extra cost. They’re convenient for employees and provide you with cost-savings through improved adherence and plan management.
- Our partnership with Express Scripts Canada, our pharmacy benefits manager, gives employees the convenience of real time claims adjudication when they go to fill a prescription. You benefit from their expertise in managing ingredient cost mark ups and dispensing fee limits at point of sale. Plus, if you choose Actively Managed Drug Solutions, the Express Scripts Canada active pharmacy approach will help employees on maintenance and specialty medications manage their chronic conditions and make smart choices—which promotes better adherence to drugs, which can result in improved health outcomes and productivity, and more control over drug plan costs.
- All our drug plans include Prior Authorization and Provincial Integration.
Get an Empire Life Prescription Drug plan working for you
To learn more about our drug plan solutions and how we can help you increase the value of your benefits program, please contact your group benefits advisor.