Employers May Become Unable to Afford Comprehensive Employee Drug
MISSISSAUGA, ON, May 28, 2014 /CNW/ - Spending on specialty drugs -
those used to treat serious, complex conditions such as multiple
sclerosis, cancer and rheumatoid arthritis - is likely to increase at a
significant rate, substantially impacting the cost employers pay to
include them in their healthcare benefit plans for employees, according
to the Express Scripts Canada 2013 Drug Trend Report released today.
Overall, specialty drugs are used by a small population of patients in
Canada, but their total cost is becoming increasingly significant. In
2013, specialty drugs made up less than 1.3 percent of all Canadian
prescriptions, but accounted for 24 percent of Canada's total spending
on prescription drugs. The average annual drug treatment cost for each
patient with cancer drug claims is $10,690, which is approximately 14
times the national average of $765 per patient in Canada. This reality
will require employers to increase the funding for drug benefits or
modify the way drug plans are structured for their employees.
"New specialty drug treatments are making a real difference in the lives
of patients, but the high cost of some of these drugs creates difficult
decisions for employers who have to decide which medications to cover,"
says Michael G. Biskey, President, Express Scripts Canada. "Our
research tells us that a large portion of the money employers spend on
overall drug benefits (specialty and non-specialty drugs) is wasted due
to poor patient decisions. The good news is that Express Scripts
Canada has solutions to help employers manage the costs associated with
the prescription drug benefit, enabling employers to sustain coverage
of specialty medications. Now is the time for employers to act so they
can continue to offer a comprehensive pharmacy benefit for their
Additional key findings from the study include the following:
Specialty spend represents only 1.3% of claims but continues to grow as
a percentage of total drug spending, steadily increasing from 13.2% in
2007 to 24.2% in 2013. This increase is primarily driven by high
treatment costs and an increase in utilization.
Spending on traditional prescription drugs - those used to treat common
conditions such as high blood pressure - declined by 1.2 %. This
downward trend is driven almost entirely by the availability of generic
drugs coupled with reduced generic prices imposed by provincial drug
Drug benefit costs are expected to increase in the future primarily
driven by the continued growth in utilization of specialty drugs.
Up to $1 of every $3 spent on drug benefits is wasted due to poor
patient decisions. Patients continue to use more expensive medications
when less expensive alternatives will provide similar health benefits.
Patients also use expensive distribution channels, use less than
optimal dispensing intervals and often fail to take prescription
medication as prescribed. This results in significant health
consequences for patients and enormous financial tolls on benefits
Traditional prescription drug benefit management tools are limited in
their ability to drive better patient decisions, which has resulted in
unnecessarily high costs and a cost shift from employer to employees.
New strategies that leverage behavioural science are proven to
influence patients to make better decisions which lower costs and can
improve health outcomes.
About Express Scripts Canada
From its corporate headquarters just outside Toronto, Express Scripts
Canada transforms the way organizations and employees think about and
participate in their drug benefit plan. Express Scripts Canada provides
pharmacy services to thousands of Canadian patients. Through its
proprietary consumer intelligence, clinical expertise, and
patients-first approach, Express Scripts Canada promotes better health
decisions for plan members, while managing and reducing drug benefit
costs for plan sponsors. Express Scripts Canada is indirectly owned by
Express Scripts Holding Company. For more information visit www.express-scripts.ca.
SOURCE: ESI Canada
For further information:
Manager, Marketing & Communications
Express Scripts Canada
905-712-8615, ext. 642256
Amanda Balla / Cindy Watson
Amanda@stratamp.com / email@example.com