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High-Cost Drugs Putting Benefits at Risk

By Andrew Rickard | May 19 2015 09:00AM

A study conducted by Express Scripts Canada, a firm that provides health benefits management services, suggests that high-cost prescription drugs pose a significant threat to private sector health plans.

photo_web_1189Express Scripts Canada’s annual drug trend report examined claims from more than seven million Canadians, and the study suggests that high-cost prescription drugs are weighing heavily on the private sector. If costs continue to rise, they could make it difficult for employers to offer a comprehensive benefits plan to employees.

The report revealed that the use of drugs to treat chronic, complex conditions such as cancer and hepatitis C has increased significantly. While expenses on specialty treatments only accounted for 2% of claims, Express Scripts Canada notes that it has continued to grow as a percentage of total drug spending, going from 13.2% in 2007 to 26.5% in 2014.

Finally, the study showed that 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," reads the report. "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."

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