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Four Key Gaps in Benefits Plans
Annual Sanofi survey zeros in on knowledge gaps in plan management

The perception out there is that a national Pharmacare program would give more Canadians more access to more prescription medications. But is that so?

Let’s start with the perception among our core groups – benefits plan sponsors and members of benefits plans – thanks to data from the 2019 Sanofi Canada Healthcare Survey.

The survey found that most people, both plan sponsors and members of benefits plans, believe that public prescription drug plans – the taxpayer funded, government-run plans for seniors, recipients of social welfare and others – cover the same number of prescription medications as private, employer funded drug plans.

But the fact, according to the CLHIA – the Canadian Life and Health Insurance Association – is that public plan coverage varies across the country, and ranges from 2,000 to 8,000 prescription drugs, for an average of 5,000. Private plans, on the other hand, cover an average of 12,000 drugs.

I suspect, though the Sanofi report does not address this specifically, that a big part of the perception gap here is that when people think about a government sponsored plan for members of the public, they confuse it with the drug plan that government employees enjoy. Somewhat ironically, civil service benefits plans, which are also taxpayer-funded, of course, are among the most comprehensive and generous in the country – but not to be confused with the “public” drug plans.

The Sanofi survey found that 42% of plan members and 22% of plan sponsors reported that they knew nothing at all about the current federal government’s plans for a national Pharmacare program.

The 2019 edition of the annual Sanofi Healthcare Survey, entitled “Closing Knowledge Gaps,” focuses on what it calls four main “gaps” in current benefits plans. The survey is based on responses from 1,505 plan members and 403 from plan sponsors.

The perception gap regarding public and private drug plans is the first issue described in the report. It notes that prescription drug coverage is the “most used and most valued” benefit, and suggests that it is important to close the perception gap to ensure that private drug plans can continue to offer coverage to plan members.

The second gap identified in the surveys is that plan members and sponsors consistently underestimate the prevalence of chronic conditions among members of the work force. The top five chronic conditions are mental illness, diabetes, hypertension, arthritis and high cholesterol. Key findings include the following:

  • over half of plan members (54%) report dealing with at least one chronic condition;
  • most plan members (87%) would like to know more about managing chronic conditions, and most plan sponsors (82%) would like more support for education from their carriers;
  • most plan members (65%) would like to receive targeted health information, and most sponsors (74%) would like insurance carriers to provide more communications resources.

It seems pretty clear to me that all five of these conditions are very broadly defined, and cover a wide range of effects, but one thing they have in common is the opportunity, in most cases, for successful long-term management. Diet and lifestyle management, driven by education and support -- as we have often discussed in this blog in the past – can have a huge impact.

Which brings us to the third gap or, as the report suggests, opportunity for improvement: expanding mental and physical fitness programs.

It struck me as very interesting, although perhaps not surprising, that plan members rated “improved physical fitness” as a priority, while plan sponsors identified “improved mental wellness.” Two sides of the same coin, if you ask me but, in any case, 51% of plan sponsors have some form of mental wellness support program in place, and 71% have plans to expand overall wellness programs – physical and mental – over the next three years.

The fourth gap – or challenge or opportunity – is revealed by the fact that roughly 80% of plan sponsors believe more needs to be done to understand “the real causes of absenteeism.” Not surprising, given that disability claims, for short- and long-term disability, can often exceed the cost of drug coverage plans. However, only 43% of plan sponsors reported that they “formally” track absenteeism, while 39% said they do so “informally.”

This is basically an information gap. If most employers are not formally tracking absenteeism, they lack the data to analyse the problem, to identify the patterns and to come up with solutions. I did find it interesting that four out of five plan sponsors wanted more information on the “real” causes, which suggests to me that they are not satisfied with the causes that are currently being listed. I’m guessing that what they really want are the “underlying” causes, and I think they’re on the right track.

This, as the report says, makes it essential to have early intervention programs in place. These include the very workplace wellness programs we have regularly talked about.

If there is a topic that you would like me to write about, please email me at bill@penmore.com

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