Drug Costs - a Primary Concern

With all benefit plans, the plan sponsor is faced with the challenge of maintaining a plan that is competitive within their industry sector while continuing to be financially sustainable. While not entirely new, the drug benefit is now the primary cost driver.

According to the 2013 Drug Spend Report prepared by Express Scripts Canada, the spending on specialty drugs has increased from 13.2% of total drug spending in 2007 to 24.2% in 2013. The high cost of new treatments and an increase in their utilizations are the primary reasons for the increase.

This increase far outdistances the positive news that spending on traditional drugs has actually decreased by 1.2% over the same period. This decrease is a direct result of the improved availability of generic drugs coupled with the reduced generic prices imposed by provincial drug reform.

Plan sponsors need to be creative in their management of the drug benefit by ensuring the administrator of the benefit uses optimal dispensing intervals, establishes appropriate distribution channels (networks providing reduced dispensing fees and discounts on maintenance drugs) while educating the plan members on the importance of taking the medication as prescribed.

New Ontario Policy on Mental Health and Addiction

The Ontario Human Rights Commission (OHRC) has released a new policy to provide guidance on how to define, assess, handle and resolve human rights issues related to mental health and addiction disabilities. The new policy builds on the OHRC Guidelines on Disability and the Duty to Accommodate and recognizes the prevalence of mental illness and addiction in Canada today (OHRC cites research estimating one in five Canadians will experience a mental illness or addiction).

The full policy can be found here

New Leaves under ESA

The Employment Standards (ESA) Amendments Act (Leaves to Help Families) - Bill 21 - received royal assent and will come into effect on October 30, 2014.

The new legislation creates three new job-protected leaves:

• Family Caregiver Leave: Up to 8 weeks of unpaid, job-protected leave for employees to provide care or support to a family member with a serious medical condition,
• Critically Ill Child Care Leave: Up to 37 weeks of unpaid, job-protected leave to provide care to a critically ill child under the age of 18, and
• Crime-Related Child Death or Disappearance Leave: Up to 52 weeks of unpaid, job-protected leave for parents of a missing child and up to 104 weeks of unpaid, job-protected leave if the child has died as a result of a crime. The child must be under age 18.

We will provide additional information as it becomes available.