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How a comprehensively managed prescription drug plan helps control plan spending

New high-cost drugs are creating financial burdens for families and employers. The Express Scripts Canada 2016 Drug Trend Report reveals that prescription drug spending in Canada has more than doubled since 2000, putting enormous pressure on private plans and presenting no clear way forward to sustaining those plans. But solutions are available to plan sponsors.

Our case studies (2016 Express Scripts Canada® Drug Trend Report - page 10) highlight how  comprehensively managed prescription drug plans help control drug plan spending.

What’s the solution?

Comprehensively managed plans provide holistic and timely interventions at key decision points, so that patients are equipped to make the best health decisions and get well. At the same time, costs are reduced for both employees and employers.

          Read: Collaborative healthcare approach puts patients at the centre of care

Comprehensively managed prescription drug plans:

  1. Help patients manage their multiple chronic conditions,

  2. Coordinate care provided by physicians and other healthcare professionals, and

  3. Help patients manage their many medications.

Comprehensively Managed Plans CurveBy doing so, comprehensively managed prescription drug plans protect the long-term sustainability of the drug benefit and help employees and their families experience better health outcomes while spending less.

So, how does a comprehensively managed prescription drug plan create better health outcomes while reducing drug spending?

Comprehensively managed prescription drug plans:

  • align treatments with clinical guidelines, reducing cost by as much as 98% with first-line therapies (2016 DTR Page 15)

  • empower patients at critical decision points

  • provide comprehensive care to patients with multiple chronic conditions

  • leverage clinical expertise and data analytics

  • incorporate synergistic management techniques, including formulary, utilization and clinical management tools

The result is the best possible care at the lowest possible cost – and a brighter future for plan sponsors and members.

            Read: Understanding high-cost, specialty drugs and your options

Implementing a comprehensively managed prescription drug plan is essential to ensure plan sustainability.

            Read: Exorbitantly priced drugs challenge Canadian families, benefit plans

At the same time – and of urgent concern to plan sponsors – the number of working-age individuals with multiple chronic conditions is rising dramatically. These patients require numerous treatments, often prescribed by many doctors and specialists without care coordination.

Read: A collaborative, patient first approach to healthcare empowers patients to make better health decisions

These trends show that more patients face increasing treatment complexity and increasing costs.  They need help managing multiple medications and ensuring that that they are using lower cost, clinically-effective alternatives when available. 

But as dire as they are, these trends also reveal opportunities to bend the drug spending trajectory in Canada.

Interested in learning more about the current state of the prescription drug landscape? See our blog: What's happening in the Canadian prescription drug benefits marketplace? Or want to learn more about how a comprehensively managed prescription drug plan can help ensure your plan’s sustainability? Talk with us today.

Express Scripts Canada