What keeps us up at night.

Each year we meet with clients, talk about the industry, changes in legislation and taxation, as well as drivers of cost increases affecting plans.  It’s the last part that most clients are concerned with as so much is beyond the control of the employer (or the broker or insurer for that matter).

There are consistent cost drivers such as the provincial dental fee guides that rise by 2 to 2.5% each year (which we are told will be double and up 4.2% this year and likely next!), then there are things like the new drugs coming to market .  This post from Benefits Pension Monitor illustrates just some of the challenges we see that will drive claims and costs for employers.


More than 140 drugs are braced for launch from Canada’s drug pipeline as they await regulatory approval from Health Canada, says Mark Jackson, a consultant pharmacist with TELUS Health. In ‘The TELUS Health Drug Pipeline Report,’ he takes a closer look at 14 of these drugs, anticipated to have the most impact on private drug plans. Cancer therapies dominate the drug pipeline and a fair share of them will be available as pills that can be taken outside the hospital which means that more cancer patients will turn to private drug plans first for coverage. Estimated costs for these drugs could reach $150,000 to $520,000 annually per patient. However, these new cancer therapies are for highly targeted uses only, based on genetic biomarkers. In one case, the estimated patient population for all of Canada is less than 200. The largest potential patient population, for a drug to treat a certain type of breast cancer, is approximately 5,500 individuals/patients. The cost is $149,300 for the recommended year of treatment. Outside of cancer, Canada’s drug pipeline includes three specialty drugs indicated for conditions with relatively larger patient populations. Private plans will see the second biologic drug for people with chronic migraines, as well as an additional biologic for severe asthma. New on the scene are specialty eye drops for dry eye, a condition that affects up to 30 per cent of people aged 50 and older. The eye drops are estimated to cost $8,700 annually. Rounding out the pipeline report are four medications for very rare conditions. All can be administered outside the hospital setting. Three are break-through therapies and one is a replacement for Soliris, which made headlines as the most expensive drug in the world when it launched more than 10 years ago. Its replacement, which can be administered every eight weeks instead of every two weeks, is expected to cost about 10 per cent less than Soliris, or approximately $605,000 annually.  http://bpmmagazine.com/news/