Although many employees do not realize it, they are partners in the success and viability of their health benefits plan. Over the years, we have figured out that our employees are just like any of our clients’ employees when it comes to benefits, so we like to drink our own Koolaid. In other words, if we think a program is good enough for our clients, it is also good for us to live it firsthand. We have implemented an Employee and Family Assistance Program (EFAP) as well as Best Doctors because we think they are terrific ways to look after our people. If our staff see the value and understand how the programs work, they can understand how the programs can work for our clients.
When our Pharmacy Benefit Manager Express Scripts Canada (ESC) decided to roll out their the Express Scripts Canada Pharmacy, we decided Benecaid would be the test case. Once we understood all of the nuances and questions that might come up, we will be in a better place to help our clients when they start on the program.
So what is the Express Scripts Canada Pharmacy and why should you care? ESC is a subsidiary of the largest pharmacy benefit manager IN THE WORLD. They really understand prescription drugs. As a result of our relationship, we are able to lever off that deep domain expertise and provide it to all of our customers large and small. If you or your dependent is on a regime of medication to treat chronic conditions such as anxiety, high blood pressure or diabetes, your medications can be delivered to home or office at no charge. In consultation with you and your physician, they can also discuss optimized treatment protocols for your specific conditions.
Why would a Plan Sponsor or their employees be interested in this? ESC has determined over many years of experience that there is a large volume of waste in the drug component of benefit plans. The waste is due to three keys areas:
1) Less than optimum amount dispensed. For chronic care medication for a stable state, the pharmacy can and should dispense 90 days supply. This will minimize the dispensing fees borne by the plan/ member.
2) Lowest cost therapeutic alternative. The physician does not necessarily consider the cost of the medication when prescribing. There may be lower cost therapeutic equivalents available to minimize the cost to the plan.
3) Adherence. If the drug is dispensed with a reasonable supply and delivered to the member, there is a much higher chance they will adhere to their regime. Forty per cent of patients are deemed non-adherent which may result in increased disability costs, additional drug therapy, increased absenteeism and loss of productivity.*
How does Express Scripts Canada Pharmacy work? All you need to do is get enrolled and a pharmacist will contact you to get started.
Convenience, cost savings and adherence. All important contributors to keeping your health benefit plan successful and sustainable for the long run!
