Prices for almost 70 generic drugs dropping by 25-40%

On April 1st the prices on the ingredient cost for almost 70 of the most common generic drugs will drop 25-40%. These drugs include those used to treat high blood pressure, high cholesterol and depression.

The discounts are based on an agreement between the pan-Canadian Pharmaceutical Alliance (pCPA)- which represents provinces, territories and federal government – and the Canadian Generic Pharmaceutical Association (CGPA). Under the new agreement, provincial and territorial governments agreed not to pursue tendering for participating drug plans over the five-year term. This agreement will more than triple the number of drugs that were discounted under the previous generics initiative.

The groups said since generic drugs covered by the agreement are manufactured by multiple companies, it will help to ensure a stable supply for Canadian patients.

Why is this significant?

The price drop applies to both public and private plans.

Plan sponsors looking for ways to manage their drug plan may want to look at applying generic substitution. For these plans since pharmacists typically offer a generic drug when it is identified as interchangeable by the province, the plan member experiences minimal disruption.

Source:
Manulife Repsource
CTV News – Prices of nearly 70 commonly prescribed generic drugs to drop under new deal
CBC News – Generic drug industry agrees to cut prices up to 40% in a 5-year deal with provinces

Upcoming Changes to the Canada Pension Plan

Canada’s finance ministers agreed to changes to the Canada Pension Plan (CPP).

1) A new mechanism will be introduced so Canadians who take time out of the workforce to raise children or due to disability don’t see a drop in their retirement benefits. The new portion of CPP will have “drop-in” provisions that will assign a higher income for those years and use that to calculate retirement benefits. The Department of Finance Canada defends the use of drop-in provisions because the “enhanced” CPP, as it is known, is based on a fixed, 40-year benefit accrual period making it easier to drop in amounts rather than dropping out years as is the case in the base CPP.

2) For child-rearing, the finance ministers agreed to a formula to drop in the average income over the preceding five-year period before a new parent took time to raise children under age seven. For those with disabilities, the formula agreed to will use 70% of the average earnings in the six years prior to the onset of the disability during the years out of the workforce.

3) Survivor benefits will be paid out to everyone, regardless of age, dependent children or disability. Even those previously denied due to their age would be eligible to re-apply for the benefits when the rules come into effect in 2019. Nor will there be any reductions in benefits for those under age 45. Current recipients will have their benefits automatically bumped up.

4) A lump-sum payment upon a person’s death will be set for everyone at $2,500, instead of being calculated based on a deceased’s earnings. The Liberals say this will help low-income workers who typically don’t receive the maximum benefit.

5) The government says the changes won’t require increases in CPP contribution rates. But Canadians will have to wait until next year to find out the actual cost to the CPP balance sheet and the effects on benefits for recipients. The chief actuary will assess the costs and effects of all the measures once the Liberals table the necessary legislative amendments to the CPP.

By Canadian Press | December 13, 2017 17:25
Source: The Canadian Press

Additional information on OHIP +

On January 1, 2018 OHIP + Children and Youth Pharmacare will allow Ontario residents aged 24 years and under to have access to many prescription drugs at no cost.

Manulife Financial has provided some important information which answers questions that Ontario residents may have regarding OHIP +

Frequently Asked Questions are answered including;
“Do I need to sing up for OHIP+?”
Where to look up if your medication is covered through the Ontario Drug Benefit (ODB) Program
“Will my doctor need to fill out a form first – through the Exceptional Access Program?”

OHIP+ Information Manulife

How long must a job be kept open for an employee on sick leave ?

We are often asked how long an employer is required to keep a position open for an employee who is off sick. If an employee is off sick with no prospect of him or her returning to work, it is understandable that the employer would need to have that position filled.
However this situation brings into account both the Ontario Human Rights Code (if the employer is located in Ontario) and the Employment Standards Act as well as additional considerations if you have a group benefits plan.

Requirements by the Ontario Human Rights Code

The Ontario Human Rights Code outlines that an employer must hold the employee’s position open to the point of “undue hardship” on the part of the employer. To claim the undue hardship defense, the organization responsible for making the accommodation has the onus of proof. The nature of the evidence required to prove undue hardship must be; objective, real, direct and, in the case of cost, quantifiable. The organization responsible for accommodation must provide facts, figures and scientific data or opinion to support a claim that the proposed accommodation in fact causes undue hardship. A mere statement, without supporting evidence, that the cost or risk is “too high” based on impressionistic views or stereotypes will not be sufficient.

Employers will also be obligated to provide the employee with termination pay of one week per year they were employed to a limit of eight weeks based on their most recent pay grade as well as vacation pay on that amount. If the employee has been with the company for more than five years (including time off on sick leave) and your payroll exceeds $2.5 million, you would also owe severance pay of one week per year to a limit of 26 weeks.

In the situation of Group Benefit Plans

If you have a group benefits plan and you cover all or part of the premium costs, you may wish to consider termination and severance payments so the company is not paying for the employee’s benefits coverage indefinitely.

Ed Canning recently wrote a great article in The Hamilton Spectator How long must business keep job open for sick worker? discussing this topic and outlines that, “increasingly, employers are developing policies which indicate that an employee who is off for more than 12, 18 or 24 months on a leave of absence will have their benefits discontinued. Maternity and paternity time off do not count. If this policy is already in place and you discontinue benefits, it will not constitute discrimination under the Ontario Human Rights Code, nor will it allow the employee to take the position that you have terminated them by discontinuing their benefits coverage. You are simply following the established policy.

Set up a policy relating to group benefit premiums and coverage for employees off on leave

As there is no law requiring you to provide benefits coverage, you can develop a policy discontinuing benefit coverage after a certain amount of time.

Canning also explains “If the employee would regularly contribute to the costs of the benefits, you can require them to continue those payments while they are off ill. You could also develop a policy indicating that after a certain amount of time, instead of paying half of the cost of the benefits, the employee has to pay 100 per cent for them to continue.”

There are various ways you could set up the policy however it is important that a policy is established and communicated to employees.

Sources:

The Hamilton Spectator, ED CANNING: How long must business keep job open for sick worker?
Ontario Human Rights Code http://www.ohrc.on.ca/en/iv-human-rights-issues-all-stages-employment/13-ending-employment-relationship

Arbitrator rules against Mandatory Generic drug plan

Mandatory Generic Drug Substitution is a drug plan feature that encourages employees to take lower cost, generic drugs whenever possible. Mandatory generic drug plans usually allow for reimbursement to employees only up to the amount of the lowest-cost alternative where a generic drug is available. Plans like this would cover band-name drugs only if a generic equivalent is not available or if the employee’s doctor completed a form indicating that the patient could not tolerate the alternative drug or that it would not work for them. Generic drugs must comply with the same federal standards as brand name drugs. They must also contain the same active ingredients, work in the same way (there are some instances where binding ingredients in the drugs may cause issues), work in the same amount of time and must look different from their brand counterpart.

Generic alternatives can be as much as two thirds cheaper than the brand name drug (Empire Life, Mandatory Generic Substitution).

Recently however an Ontario arbitrator has struck down an employer’s use of mandatory generic substitution in their benefits plan. As reported in Benefits Canada arbitrator Russell Goodfellow ruled on a grievance by United Steelworkers Local 1-2010 that challenged Eacom Timber Corp’s move to mandatory generic substitution in 2016.

The change to mandatory generic substitution was not negotiated in the collective agreement, and Goodfellow ruled that the company could not impose mandatory generic substitution saying “A prescription drug is a drug prescribed by a physician”. The company, Goodfellow noted, was trying to cut costs by limiting the circumstances in which employees could access brand-name drugs. “In my view, that is contrary to the collective agreement,” he wrote. “It reduces or limits the agreed-upon benefit.”

This case highlights the importance of communication around benefits and what any changes to the benefits program means to employees.

Sources: Empire Life, Mandatory Generic Substitution
Benefits Canada

Online therapy to support mental health

According to the Centre for Addiction and Mental Health (CAMH), one in five Canadians experience a mental health issue in any given year, making it a leading cause of disability in Canada. In fact, almost 30 per cent of all group disability claims at RBC Insurance are related to mental health.

Cognitive Behavioural Therapy is effective in the treatment of anxiety and depression as well as other mental health issues. There are some factors however that deter people from engaging in face to face therapy. For some people finding the time, access to care and fear of embarrassment are all issues that can prevent those who need care from seeking it.

A study by the University of Regina partnered with The Co-operators Group Ltd. is being conducted to explore the benefits and challenges of online cognitive behavioural therapy and the level of interest among employees. Research by the University of Regina in the past has shown that online therapy is effective in improving mental health and day to day function.

For many people accessing care online from the comfort of their home is convenient and often preferred. “25 percent of people accessing our online therapy unit say this is the first time they felt comfortable seeking help” notes Heather Hadjistavropoulos, a professor of psychology at the University of Regina and director of the online therapy unit.

Also taking into account that the workforce is comprised more and more of employees who have grown up with computers and smart phones and who are very comfortable with turning to online sources for help. Digital options for mental health makes sense.

RBC Insurance has signed an exclusive agreement with Best Doctors Canada to provide RBC Insurance’s disability insurance clients with industry leading mental health support and advocacy. The program called “Onward™” is geared towards helping clients with depression, anxiety and other mental health concerns, get healthy, productive and back to work sooner. Given that early intervention is critical when dealing with mental illnesses, the Onward by Best Doctors™ program provides rapid access to psychologists. The program includes 12 therapy sessions that can be conducted digitally from the comfort of home, eliminating the stress and cost of travel to an appointment. In addition, the program provides diagnosis and treatment recommendations from a leading psychiatrist to the client’s physician while assigning an advocate to each client to guide them throughout the entire process.

Sun Life Financial introduced a new business area called digital health solutions to help Canadians access the latest in digital capabilities and innovations to take care of their health and well-being.

This fall, Sun Life is launching ‘Ella’, an interactive digital coach who will help Clients fully utilize their benefits and pension plans. This new technology, which will be available first online and through Sun Life’s mobile app soon after, will help Clients appreciate the plans provided by their employers like never before, helping them to achieve lifetime financial security and live healthier lives. Sun Life intends to make “Ella” an increasingly interactive tool that connects employees to applicable resources.

The trend of using technology to deliver health and wellness services continues to grow, providing more flexible options for employees looking for assistance.

Sources:
RBC Insurance Launches Exclusive Industry Leading Mental Health Program
Newswire.ca “Two Leading Organizations Partner for Research Study on the Benefits of Internet-Delivered Cognitive Behavioural Therapy Supporting Mental Health Care”
Benefits Canada ” Assessing the impact of online therapy as digital health tools proliferate”
Sun Life introduces ‘Ella’, an interactive digital coach to help Clients navigate and maximize their benefits and pension plans

Update to Trillium Drug Program Changes

In an earlier post, we had let you know that changes to Ontario’s Trillium drug program were planned for fall 2017. The Trillium Drug Program (TDP) is a provincial government program for residents of Ontario that have high drug costs in relation to their household income.

These changes were to enhance the Health Network System (HNS) and supporting systems to allow for co-ordination of benefits (COB) between private insurance plan(s) and the Trillium Drug Program at the pharmacy once the initial claim has been adjudicated by the private plan(s).

It has now been reported by Benefits Canada that the Ontario Ministry of Long-Term Care has indicate that these changes will not be happening by September as previously believed.

While the automatic coordination of benefits between Trillium and private insurance providers is still planned, no indication of timing was given. It was noted that Ontario’s new pharmacare program for youth and children could be a source of “further learning” about the co-ordination of benefits. The pharmacare program for youth and children will be in place January 2018.

Source: Benefits Canada “Trillium changes pushed back as Ontario seeks “further learning” about co-ordination”

Employee well being – supporting financial literacy

Stresses surrounding personal finances can affect employees’ productivity at work as well as their general well being. Financial stress is repeatedly linked to poor health, fatigue, anger, depression and heart attacks. Employees who have a better understanding and control over their personal finances have less stress, which translates to increased productivity at work.

“We know that worries about personal finances are at the top of the list when Canadians talk about excessive stress. And as each of us know only too well, stress isn’t something you can tuck away in a drawer or leave at home. It comes with us to work where it can be a distraction that affects employee work performance and leads to absenteeism.” – Jane Rooney, Canada’s Financial Literacy Leader.

In past blog posts, we have discussed how Employee Assistance Programs can support employee well being and reduce stress at work. Employers who invest in Employee Assistance Programs based on financial education, can achieve an overall healthier workforce that is motivated and more successful on both a personal and professional level. A good financial literacy program should consider all employees from someone just entering the workforce to someone at retirement age. The financial concerns and stresses of employees in different age groups or life stages would be very different.

The Financial Consumer Agency of Canada has many free programs, tools and resources for employers.

If delivered properly, an employee financial literacy program can reduce employee stress and the associate health concerns and can result in increased productivity and more engaged employees.

Sources:
Government of Canada – Workplace Financial Literacy

Benefits Canada Financial literacy and your bottom line Financial literacy and your bottom line

BDO First Call Debt Solutions Financial Literacy plays a Big Role in Reducing Debt Stress & Bankruptcy in the Workplace

2017 Sanofi Canada Healthcare Survey

The 20th anniversary of The Sanofi Canada Healthcare survey on health benefit plans has been released.

Just over half of plan members (53%) state their health benefit plan meets their needs extremely or very well, and another 39% say it does so somewhat well.

Highlights from the 2017 Survey

Impact of Wellness Programs

Plan members with access to workplace wellness programs are much more likely to give top marks to their benefit programs than those without for both the meeting of needs (63% versus 46%) and quality (57% versus 42%) of their benefit programs.

Traditional versus flex

Currently, 77% of employees report having traditional benefit plans, which define what is covered and the levels of coverage.
However, 54% of employees would prefer a flex plan, where employees can choose types and levels of coverage. Health spending accounts (HSAs), which provide employees with a certain amount of dollars every year to spend as they wish on allowable health-related items or services, are another way to bring some flexibility into benefit plans.

Employees with HSAs are more likely to agree that their plans meet their needs very or extremely well (60% versus 50% among those without HSAs); currently, 31% of employers offer health spending accounts, increasing to 47% among employers with 500 or more employees.

Underestimation of Chronic Disease

More than half of plan members (57%) report being diagnosed with at least one chronic disease or condition, consistent with results in 2015 and 2016.

This increases to 72% among employees aged 55 to 64. Plan sponsors, meanwhile, continue to significantly underestimate the presence of chronic conditions in their workforce, at just 32%, unchanged from last year.

More than a third (37%) of employees with chronic conditions take three or more medications on a regular basis and are therefore the most frequent users of drug benefits plan. A convincing 73% of them would be interested in coaching from a pharmacist to learn more about their medications and conditions, if this were covered by their benefit plan.

Impact on stress management

When we look at personal behaviours that are considered contributing factors for chronic disease, 22% of surveyed employees report that the workplace negatively impacts their ability to manage stress. This climbs to 44% among those who are dissatisfied with their current jobs. Some other behaviours negatively affected by the workplace include sleep health (16%) and eating healthier foods (9%).

Mental Health in the Workplace

Mental health is one of the fastest growing categories of disability costs in Canada. 500,000 Canadians in any given week are unable to work due to mental health problems or illness.

The costs of mental health includes the long-term economic costs of healthcare, disability income and lost productivity.

Early intervention on mental health issues in the workplace can reduce disability costs, increase productivity, and improve the lives of your employees.

What can employers do?

Many organizations have adopted some type of employee assistance program (EAP) to support wellness, but more can be done. For example, employers can sponsor sessions on stress management or provide mental health specific training for managers. Managers work with employees on a day to day basis and can be trained to recognize early warning signs that may indicate that an employee is under stress.

Canada has released a national standard for mental health in the workplace. The National Standard of Canada for Psychological Health and Safety in the Workplace is the first of its kind in the world. The standard is voluntary, however it is designed to help organizations improve workplace mental health and wellness. It includes a set of voluntary guidelines, tools and resources intended to guide organizations in promoting mental health and preventing psychological harm at work.

Source:
Sun Life Mental Health in the Workplace
The National Standard of Canada for Psychological Health and Safety in the Workplace