Businesses Warned: High-Cost Prescription Drugs Put Employees’ Pharmacy Benefit at High Risk

Express Scripts Canada Offers Solutions to Maintain Key Employee Benefit

MISSISSAUGA, ON, May 14, 2015 - Express Scripts Canada, one of Canada’s leading providers of health benefits management services, today announced the results of its annual Drug Trend Report, which features research and data on the use of prescription medications in the private sector in Canada. According to the report, which is based on millions of drug claims from more than seven million Canadians, high-cost prescription drugs are significantly threatening the ability of private sector employers to offer a comprehensive prescription drug benefit to employees.

Spending on high-cost prescription drugs — such as those used to treat chronic, complex conditions like cancer and hepatitis C — grew at alarming rates in 2014. Spending on traditional prescription medications, like drugs used to treat common conditions like diabetes and high cholesterol, is also expected to grow in the coming years. Together, these increases will impact the sustainability of a benefit that many Canadians rely on.

Innovative managed solutions that leverage actionable data, behavioural science techniques, clinical expertise and patient support tools help patients manage their health conditions and make better decisions which lower costs and can improve health outcomes.

“Pharmacy benefits have become one of the most high-profile areas of employee health plans, from both an economic and employee satisfaction standpoint,” says Michael Biskey, President, Express Scripts Canada. “However, current trends show that Canadian businesses should act today to implement innovative solutions to sustain this important benefit. The day may come when employers might not be able to afford the prescription drug benefit. Express Scripts Canada works closely with companies across Canada to implement solutions that help balance costs and encourage healthier outcomes for employees. Our solutions are a win-win for employees and employers.”

Additional key findings from the study include:

  • Specialty spend represents only 2% of claims but continues to grow as a percentage of total drug spending, steadily increasing from 13.2% in 2007 to 26.5% in 2014. This increase is primarily driven by high treatment costs and an increase in utilization.
  • Spending on traditional prescription drugs - those used to treat common conditions such as high blood pressure - declined by 0.3 %. This slight downward trend is driven by lower generic prices resulting from pan-Canadian Pharmaceutical Alliance pricing agreements, as well as an increase in the availability of generic options due to patent expiries.
  • Drug benefit costs are expected to increase in the future primarily driven by inflationary pressure from new high-cost brands for both traditional & specialty drugs.
  • Up to $1 of every $3 spent on drug benefits is wasted due to poor decisions. Patients continue to use more expensive medications when less expensive alternatives will provide similar health benefits. In addition, patients also too often make expensive pharmacy choices, use less than optimal dispensing intervals and fail to take prescription medication as prescribed. This results in significant health consequences for patients and enormous financial tolls on benefits providers.

About Express Scripts Canada

From its corporate headquarters just outside Toronto, Express Scripts Canada transforms the way organizations and employees think about and participate in their drug benefit plan. Express Scripts Canada provides pharmacy services to thousands of Canadian patients. Through its proprietary consumer intelligence, clinical expertise, and patients-first approach, Express Scripts Canada promotes better health decisions for plan members, while managing and reducing drug benefit costs for plan sponsors. Express Scripts Canada is indirectly owned by Express Scripts Holding Company.

For further information:

Nancy Tibbo
Manager, Marketing & Communications
Express Scripts Canada
905-712-8615, ext. 642256