Putting the health of Canadians first 

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Mercer’s model for a national high-cost drug program

The Government of Canada recently opened consultations on a national strategy for high-cost drugs including rare disease – the next step towards a national pharmacare program. Employers and plan sponsors have told us that they would welcome a strategy that improves access to innovative therapies and does not impose added costs or risks for their business.

Our submission to Health Canada recognizes the ongoing role for private plans in delivering a national strategy – one that delivers for all Canadians.

Private drug plans have a long track record of success in ensuring that Canadians get the treatments and therapies they need. Any national strategy for high-cost drugs must therefore be developed collaboratively with plan sponsors and employers, both in the creation of any public program and in the execution of that program.

A national strategy must:

  • Put competitiveness first by not increasing the tax burden on businesses
  • Enhance the ability of private plans to support workforce well‑being, by preserving their flexibility
  • Respect existing employment contracts and collective agreements, by not mandating coverage or required design terms

Three pillars for a national drug plan

At Mercer, we agree with Health Canada’s three pillars for a national high-cost drug plan including rare disease. Any strategy selected must be accessible, evidence-based and sustainable.
  • Accessibility

    • Delivered in a patient-focused manner
    • Created in collaboration with plan sponsors and employers
  • Evidence ‑ based

    • Assessments to impacts to workplace health and productivity
    • A national expert panel that includes employer representation
    • A national data system
  • Sustainable

    • Funded in a way that helps business remain competitive
    • No mandated formulary or required design

As a plan sponsor, you know how important it is that your workforce remain healthy. Implemented properly, a national strategy for high‑cost drugs would be a win for both you and your plan members. It would improve your plan’s sustainability, and in doing so, help you support the health and well‑being of your workforce.

But for that to come to pass, we must see a national strategy that allows plan sponsors the flexibility and the competitiveness to keep doing what you do best, while mitigating the risks posed by high‑cost drugs.

In doing so, it will deliver for both employers and employees – and bring Canada one‑step closer to completing the promise of universal healthcare.

Contact a Mercer consultant for insights on what this means for your organization.

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