News

Gaps in access to drugs in Canada
Canadian patients have less access to the latest medicines when compared to the world’s developed countries, according to the Rx&D International Report on Access to Medicines 2008-09 prepared by Wyatt Health Management. When it comes to public reimbursement of new drug therapies, Canada ranks 20th out of 25 OECD countries studied. Canadians also pay higher than average out-of-pocket expenditures for drugs. Canada is tied for last with the U.S. on the relative public expenditure on drugs at 37.5% but the country’s private drug plans contribute the highest (44.1%) relative amount to the cost of drugs, compared to the 14.8% average of other countries. The full report, released Nov. 2, 2009, is available as a pdf at www.patientscomefirst.ca.

New pharmaceutical strategy in Alberta
The next phase of Alberta’s pharmaceutical strategy aims to reduce the out-of-pocket costs of prescription drugs for all Albertans, allow for quicker access to new drugs and give pharmacists a greater role in patient care, says Alberta Health and Wellness Minister Ron Liepert. He also announced that pricing of new generics will be set at 45% of the brand price, although the pricing level for existing generics will not change for now. There are no plans for direct intervention into or regulation of manufacturer allowances, but Alberta’s Health Ministry has created a transition plan to support pharmacies as they become increasingly involved in delivering expanded professional services. Source: "RxA releases more details of Alberta’s pharmaceutical strategy," Barbara Kermode-Scott, posted at www.canadianhealthcarenetwork.ca, Oct. 22, 2009.

Regional differences in attitudes to wellness
Nearly half of respondents to this year’s edition of The sanofi-aventis Healthcare Survey said they would choose health benefits over $20,000 cash. This was especially true (58%) for those living in B.C., while Albertans (56%) topped the list of those who said they would prefer the cash rather than benefits. Although nearly one-third (31%) of respondents said they have access to a health and wellness plan through work, few (35%, down from 40% in 2008) use them. Program use was strongest in B.C. (50%) and lowest in Alberta (21%). The 12th annual survey also found that personal finances are a top issue for respondents with high stress, especially those in Alberta and B.C. Source: "Recession not the time to trim health benefits," Working Well, October 2009, p. 6.

Conference examines ways to manage impact of chronic disease
Speakers at this year’s Solutions in Drug Plan Management Conference focused on how employers can better manage the impact of chronic disease. Better compliance with medications to treat chronic conditions such as allergic rhinitis can lower healthcare costs, reduce absenteeism rates and boost productivity, noted Christine Hampson, president & CEO of the Asthma Society of Canada. Gail Attara, executive director of the Society of Intestinal Research, spoke about the need for open formularies and the negative impact of therapeutic substitution, while Mike Sullivan, president of Cubic Health Inc., encouraged employers to find space in an existing budget to put wellness programs in place. Source: "Making health happen," April Scott-Clarke, Working Well, October 2009, pp. 29 - 30.

Chronic pain requires aggressive therapy up front
One in three Canadians report they live with moderate or severe chronic pain in their day-to-day lives, according to a survey conducted in 2007 for the Canadian Pain Society. As well as taking a heavy personal toll, chronic pain also affects the workplace when employees take time off for diagnostic testing and can’t work at full capacity because of pain. To curb the potential long-term cost burden of disability and drug claims, employers should be aggressive at the onset of a claim. "You have a window of opportunity in the 8-12 week range where you can take some of those people and, with good multidisciplinary therapy, turn them around and get them working," says Dr. Roman Jovey, program medical director, CPM Health Centres. Source: "Dulling the [chronic] pain," Anna Sharratt, Working Well, October 2009, pp. 24 - 25

Global trend toward choice in benefits
A Mercer poll of more than 1,700 organizations in 47 countries found that one in four employers now offers choices within their benefits plan, and one-third of those that do not offer choices are considering doing so. The primary reason for providing choice is to "respond to diverse workforce needs and values," but a further factor is the ability to manage costs. Nearly one-third of organizations offering program choices said the strategy had helped them to reduce benefit costs. As well, 62% of all respondents said that to increase employees’ understanding and appreciation of benefits would be a very important priority for their health and benefits programs for the next few years. Source: "Employers offering increased benefits choices," Jody White, posted at www.benefitscanada.com, Oct. 30, 2009.

More flex in Canadian benefits
Canadian employers with flexible benefits plans have managed to contain benefits cost increases and attract and retain the employees they need to regain and grow their business, according to Hewitt Associates’ Flexible Benefits in Canada 2009 survey of 211 Canadian organizations. Six in 10 organizations now offer a benefits plan with a flexible component, up from 41% in 2005. Three-quarters of employers with flex plans say these programs are meeting or exceeding their expectations in terms of meeting diverse employee needs, containing rising benefits costs and improving employee recruitment and retention. Organizations are also adding new options to their lineup of benefits such as wellness accounts, critical illness insurance and health club memberships. Source: "Briefly: ‘The best benefits plans are flexible’," posted atwww.benefitscanada.com, Oct. 14, 2009.

Nine out of 10 employers offer wellness
Ninety-one percent of Canadian employers offer at least one wellness initiative—a 47% increase since 1997. The National Wellness Survey, conducted by Buffett & Company and sponsored by Sunlife Financial and Pfizer Inc., is based on results from 634 employers across Canada. While the results are promising on one level, further analysis reveals that employers need to be more strategic in their wellness activities, in particular by targeting the health risks of their specific employee populations. Source: The 2009 National Wellness Survey, Buffett & Company Worksite Wellness Inc., press release available at www.buffettandcompany.com.

Drug Plan Management Forum
Working Well’s Face-to-Face Drug Plan Management Forum 2009 will take place on Tuesday, Dec. 1, 2009 at Sutton Place Hotel in Toronto. This half-day conference brings together plan sponsors, group insurers, benefits consultants, pharmaceutical companies and other healthcare stakeholders to discuss drug plan management issues. It’s an opportunity for stakeholders to share common challenges and joint solutions. For more information, go to www.hfconferences.ca/facetoface/drugplan/index.htm.

Cancer Society calls for catastrophic drug program
The Canadian Cancer Society has released a report calling for a catastrophic drug program to help ensure that Canadians can afford cancer treatment. With an average price tag of $65,000 for treatment with the newer cancer drugs, access is largely dependent on public and private insurance. While drug plans usually do provide coverage, some have co-payments, spending caps or restricted formularies. Source: "Cancer Drug Access for Canadians," Canadian Cancer Society, Sept. 2009, available at www.cancer.ca.

U.S. employers shift more costs to employee
Nearly 40% of U.S. employers are likely to raise annual deductibles and the amount  employees pay for prescription drugs, according to an annual survey released by the Kaiser Family Foundation and the Health Research and Educational Trust. Faced with rising healthcare costs, 9% of those surveyed said they plan to tighten eligibility for health benefits and 8% said they plan to drop coverage entirely. Other strategies for reducing benefits costs include financial incentives for weight-loss programs, mail-order prescriptions and health risk assessments. Source: "Many Employers to Raise Cost of Health Benefits, Survey Finds," David S. Hilzenrath, posted at www.washingtonpost.com, Sept. 16, 2009.

Pharmacy services could save millions
A study conducted by nD Insights and released by the Ontario Pharmacists’ Association (OPA) found that pharmacists could provide the healthcare system with gross savings of $473 million over the first five years by playing bigger roles in chronic disease management and medication therapy management. The study also estimates $13.6 million in savings over five years from a health, wellness and disease education program for people with asthma, diabetes and hypertension; and $3 million per year by year five from a prescription intervention program to assist pharmacists in preventing adverse drug events. Source: "Ontario study shows value of pharmacy services," Sonya Felix, posted at www.pharmacygateway.ca, Sept. 09, 2009.

Aging workers present healthcare cost challenges
A number of reports by Mercer and the Organization for Economic Cooperation and Development (OECD) outline the strategic challenges facing retirement and healthcare industries and offer solutions for policymakers and employers alike who must address an increasing elderly population. Healthcare costs are a key concern for employers attempting to retain older workers. Initiatives such as coaching and onsite or online health facilities can help control costs and boost productivity. Source: "Tomorrow’s retirement and healthcare to be collaborative effort: report," Jody White, posted at www.benefitscanada.com, Sept 02, 2009.

Coaching employees for better health
Employers are increasingly aware of the value of in-house healthcare programs as proactive preventative measures. Health coaches act as mentors and educators who work with employees so they become advocates for their own health, and provide encouragement, information and personalized programming so that employees can recover from existing health issues and achieve healthier lifestyles. Health coaching should be aligned with organization-specific data: drug plan data, health risk appraisals, STD and LTD statistics and workers compensation injury reports. Work productivity scales using standardized measurement tools may also determine how an employee’s health status is affecting him or her at work. Source: "Training Day," Brenda De Jong, posted at www.benefitscanada.com, Sept. 01, 2009.

Antibiotic use decreases with universal flu vaccine
A program of universal flu vaccination sharply reduces inappropriate antibiotic use, according to a study published in Clinical Infectious Disease. After Ontario’s universal flu shot program began in 2000, the rate of influenza-associated antibiotic prescriptions fell 64%. In contrast, the rate of such prescriptions did not change significantly in other Canadian provinces where flu vaccination was targeted to specific groups. Researchers say the finding is important because overuse of antibiotics – especially in cases of viral illness, when they have no effect – can lead to drug resistance. Source: "Universal Flu Shots Cut Antibiotic Use," Michael Smith, posted at www.medpagetoday.com, Aug. 21, 2009.

Watch out for abuse of narcotics
Plan sponsors may be surprised to learn how much narcotics and other controlled drugs are abused or diverted by private drug-plan beneficiaries. Although some plan sponsors assume that pharmacies, insurance carriers and/or claims processors have controls in place to prevent this, that is not always the case. Plan members may be walking out of pharmacies with dangerous amounts of narcotics, paid for by the private plan sponsor, that are misused and/or sold for profit on the street. Plan sponsors need to take a look at blinded claims data to determine if suspect cases of narcotic or control drug abuse exist. Source: "Narcotic abuse and drug diversion inside your plan," Mike Sullivan, posted at www.benefitscanada.com, Aug. 20, 2009.

Drug Innovations Forum set for September
The Drug Innovations Forum, presented by Working Well magazine, will be held on Wednesday, Sept. 23, 2009 at the Sutton Place Hotel in Toronto. This annual event brings together leading innovators of Canada’s pharmaceutical industry to provide employers, group insurers, benefit consultants and other healthcare stakeholders with a forum to showcase pharmaceutical advances. Agenda topics this year include disease therapy management in specialty pharmacy, diagnostics for personalized cancer treatment, diagnostics for personalized cancer treatment and fertility treatment options for couples. For more information, go to www.hfconferences.ca/innovations.

U.S. employers use cost sharing in drug plans
Three-quarters (76%) of U.S. employers are using cost sharing to help manage prescription drug programs, according to a survey by Buck Consultants. The most common target cost-sharing range is between 11% and 20% of claim costs. Employers are also taking special note of care management, disease management and low-cost generic pricing programs offered by retail pharmacy chains. Top priorities in managing specialty drug therapies include adhering to clinical guidelines, clinical management and centralized distribution. Source: "Employee cost-sharing up sharply in prescription drug plans", posted atwww.benefitscanada.com/acrossborders, Aug. 6, 2009.

Private payers lose out under Bill 102
Ontario’s drug benefit plan saved saved $252 million in 2008/2009 through lower generic prices and some volume discount agreements with brand-name drug manufacturers, but private payers haven’t seen similar reductions in drug prices--a reality that employers are "starting to wake up" to, says Barbara Martinez, senior health and benefits associate with Mercer Human Resources Consulting in Toronto. In Ontario, the provincial public plan and the private plans traditionally paid the same price for the ingredients and mark-up on drugs, with the key difference in cost being the amount of the dispensing fee. Now "there is a terrible disparity in prices," says Martinez. Source: "Private payers ‘wake up’ to drug price gap," CMAJ, Ann Silversides, posted at www.cmaj.ca/earlyreleases/4aug09_generic_drugs.shtml, Aug. 4, 2009.

Drug costs on rise again
Prescription drug spending has dramatically reversed its decline of the last few years by rising 15.2% in 2009. Contributing factors include an aging population and a higher incidence of people taking medications to treat cancer, depression, rheumatoid arthritis and cardiovascular conditions. Yet, while drug costs rise, it’s important to recognize that improved compliance with prescriptions may avoid the need for specialized health care, hospitalization and surgery with related time off work. Source: "Canadian Health Care Trend Survey Results 2009", Buck Consultants, available at www.acsbuckcanada.com.

Pharmacists can help with weight management
One in 10 premature deaths of Canadian adults is directly attributable to obesity, according to a panel of Canadian experts in obesity, primary care, pharmacy, nutrition and consumer wellness. One of the obstacles facing patients in their weight loss goals is lack of access to effective, safe and proven pharmacotherapies. The panel would like to see more evidence-based therapies made available over-the-counter so that consumers don’t turn to so-called dietary supplements that have no evidence of safety or efficacy, notes Tom Smiley of Pharmavision Health Consulting Inc. In addition to pharmacotherapies, people need access to a full range of healthcare professionals such as pharmacists, dietitians and counsellors. More than 1,000 pharmacists across Canada have recently received specialty training in obesity management. Source: "Patients need access to treatment: panel," Conduit magazine, Canadian Obesity Network, Summer 2009, p. 18.

Wellness programs can reduce rising costs
Despite the recession, benefit plans aren’t necessarily on the chopping block, says Michele Bossi, a Toronto-based practice leader in the health and productivity consulting practice at Buck Consultants. Benefits are a huge cost but remain important for attracting and retaining talent. Although wellness programs are one way to reduce costs, many organizations now have data reviews and are looking at benefit usage. It’s a matter of deciding where to target efforts and some employers have a too broad-based wellness strategy, says Estelle Morrison, director of health management at HR services firm Ceridian Canada. Source: "Healthcare costs maintain dramatic rise," Sarah Dobson, Canadian HR Reporter, July 13, 2009, pp. 1, 14.

Mandating health checkups
When voluntary wellness programs didn’t get employees to change their health habits, AmeriGas Propane Inc, based in Valley Forge, Pa, decided to mandate health testing for employees as a condition for health insurance coverage. Beginning last year, all employees had to get physical exams, blood-pressure checks and cholesterol and blood sugar tests. More than 90% of workers have since completed the required exams, while use of cholesterol drugs rose 14.6%, diabetes drugs increased 7.7%, while use of asthma and anti-hypertensive drugs grew 7.4% and 2.5% respectively. Source: "When All Else Fails: Forcing Workers Into Healthy Habits," Anna Mathews, posted at http://online.wsj.com, July 8, 2009.

CLIHA recommends public/private partnerships
With demands on public healthcare expected to rise exponentially over the coming decades as the population ages, the Canadian Life and Health Insurance Association (CLIHA) is pushing for more public/private partnerships to ensure Canadians get the healthcare they need. A CLIHA report on healthcare policy recommends that federal, provincial and territorial governments work with the insurance industry to establish catastropic drug coverage for all Canadians and ensure equitable drug pricing in private and public programs. The report also recommends creating a more competitive generic drug industry in Canada and states that "lower drug prices mean more affordable drugs for Canadians, savings for government plans, and more affordable supplementary insurance coverage, which in turn, will increase access to prescription drugs for more Canadians." Source: "CLHIA makes case for healthcare overhaul," Mark Noble, posted at www.benefitscanada.com, June 3, 2009.

Recession no time to cut health benefits
Reducing the delivery of health benefits is likely to increase costs elsewhere in the organization as employees’ experience increased levels of stress and health issues. That’s one of the findings of the 2009 Sanofi-Aventis Healthcare Survey of 2,090 health benefit plan members. A majority of respondents (57%) said they have had difficulties accessing prescription medicines not covered by their health benefit plan. The survey also reveals tangible returns from a well-run healthcare program: companies offering health promotion programs are more likely to have their health benefit plans rated as excellent or very good, and have employees who feel more satisfied with their jobs and obligated to help control benefit costs. To access the survey, go to www.sanofi-aventis.ca.

Negative impact of cutting drug plan deductibles
Employers may be tempted to trim health coverage costs by raising deductibles on drug plans, but the impact can be disastrous, according to a case study presented at Morneau Sobeco’s Emerging Trends 2009 seminar. Higher than anticipated short-term savings resulted from a drop in pharmaceutical usage, as many employees could no longer afford their medication. Anti-inflammatory drug use fell 45%, hypertension drug use fell 26%, antidepressant drug use fell 26%, and anti-diabetic drug use fell 25%. As employee health suffered, though, costs increases associated with falling productivity outweighed any costs saved on the drug plans. Source: "Cutting healthcare can cut productivity," Steven Lamb, posted at www.benefitscanada.com, May 25, 2009.

Solutions conference set for June 23
Canadian case studies and multi-stakeholder roundtable discussions will be featured at the ninth annual Solutions in Drug Plan Management conference, scheduled for June 23 in Mississauga. Attendance is by invitation only; if you have not received an invitation and would like to attend, please email Karen.welds@rci.rogers.com.

Wellness programs useful in tough times
Health benefits are an important part of compensation packages that retain employees and help employers compete in the labour market. But benefits are expensive, and during the current economic crisis many companies are looking for ways to reduce costs. Although cost-effective, scaling back benefits can have a negative impact on morale and corporate culture. Employers should instead consider wellness programs, which have proven to improve morale, increase employee health and productivity, and reduce turnover. Such programs provide employers with a return on investment as much as eight times greater, by lowering health insurance premiums and reducing disability claims. Source: "Getting the most out of your healthcare spend," William Yatscoff, posted at www.benefitscanada.com, May 5, 2009.

Health Canada’s priorities skewed, says study
Health Canada favours rapid approval of new drugs at the expense of a post-marketing pharmacosurveillance system, says a new report published by the Canadian Centre for Policy Alternatives. According to the report’s author, Dr. Joel Lexchin, the number of people exposed to harmful drugs that are eventually pulled from shelves is increasing, due to pressure to get new pharmaceuticals to market quickly. Among recommendations made in the report: making treatment safety information publicly available after approving a new drug; ensuring independent post-market studies are undertaken, analyzed and reported on; and undertaking a systematic study to examine whether faster drug approvals lead to more post-marketing safety issues. The full report can be downloaded at: www.policyalternatives.ca/~ASSETS/DOCUMENT/National_Office_Pubs/2009/
Drug_Safety_and_Health_Canada.pdf.
Source: "Quick approvals trump drug safety: report," Brett Ruffell, posted at www.pharmacygateway.ca, April 22, 2009.

Still opportunities to reduce drug spending
Drug plans’ annual inflation rates have fallen from the double-digit figures seen in the 1990s to single digits today. But that doesn’t necessarily mean that current plans are better managed. Plan sponsors are still leaving between four and eight percent of their plan spending sitting on the table, on average, because their existing plan experience is not optimized. But opportunities do exist for sponsors to realize immediate savings and better position themselves going forward. In the U.S., for example, despite the highest brand-name drug prices in the world, sponsors have kept inflation low through actively managed plan designs. Source: "Cost Increases Within Canadian Drug Plans: What’s the Real Story?" Mike Sullivan, posted at www.benefitscanada.com, April 20, 2009.

Private sector drug spending outpaces public side
Private sector prescription spending outgrew public sector expenditures last year, according to the latest Canadian Institute for Health Information (CIHI) report on health care costs. In 2008, total spending on prescription and OTC drugs reached almost $30 billion, or $900 per person. Private sector prescription payments grew by 11 percent to reach an estimated $14 billion, compared to a seven percent growth rate for the public sector. Some experts attribute private sector growth to provinces exchanging age-based entitlement programs for income-based drug benefit programs. As well, baby boomers’ spending on prescriptions has grown faster than any other population group, with many of those payments happening on the private side. Source: "Drug spending hits $30B in 2008," Brett Ruffell, posted at www.pharmacygateway.ca, April 17, 2009.

More evaluation of wellness programs needed
Evidence to support the benefits of wellness and disease management programs is severely lacking, and even when evaluations are done they are often done poorly. Why should employers care? Without a solid body of peer-reviewed studies, it is difficult to learn from others and improve programs that have been implemented. To properly evaluate a wellness program, you must use a study design that can determine the program’s impact with confidence. The evaluation must clearly define the components of the wellness program to understand what is being measured. Rather than focusing on economic outcomes alone – such as changes in drug costs – the study should include economic, clinical and humanistic outcomes. Source: "Wellness programs: failure to evaluate, Neil J. MacKinnon", posted at www.benefitscanada.com, April 14, 2009.

Antidepressant scripts not filled when money scarce
A recent study by the Centre of Addiction and Mental Health (CAMH) raises concerns about the treatment-related decisions of people on short-term disability. An analysis of administrative disability data for three large firms, comprising 63,000 employees nationwide, found that an employee on depression-related short-term disability is less likely to fill a prescription for antidepressant medication if the individual is already paying high out-of-pocket costs for medication to treat physical disorders such as heart disease or asthma. This tendency may present a barrier to accessing antidepressant treatment, impact the person’s recovery and hurt the employer’s bottom line through lost productivity. Source: "Anti-depressants forgone when money is scarce," Sheryl Smolkin, Employee Benefit News Canada, posted at http://ebnc.benefitnews.com, April 13, 2009.

NPS would be positive for plan sponsors
If implemented, Canada’s National Pharmaceuticals Strategy (NPS) would have a dramatic impact on employers, says Dr. Neil MacKinnon, a contributor to the Health Council of Canada’s recent reports on the NPS. For example, a common drug formulary would change the drugs that are reimbursed by plan sponsors, and lower drug prices could result from a more Pan-Canadian effort on negotiating with drug companies. Although the NPS has lost energy since 2004, MacKinnon says a renewed national approach should include the private sector at the table. Source: "Drug Watch," Jody White, posted at www.benefitscanada.com, Feb. 28, 2009.

Program to educate physicians about drugs
Ontario will soon become the fifth Canadian province to launch an academic detailing program to disseminate evidence-based drug information for physicians. Such programs—already running in British Columbia, Nova Scotia, Saskatchewan and Manitoba—are shown to promote better prescribing. The Ontario program, funded by the province’s Ministry of Health and Long-Term Care, is intended to encourage the use of the most therapeutically appropriate and cost-effective medications for each patient; to provide objective, evidence-based comparative drug information to physicians; and to reduce provincial drug expenditures. Source: "Ontario starting academic detailing," Sonya Felix, Drugstore Canada, March 2009, p. 13.

Bill 102 shifting costs to private sector
Ontario’s government has been successful in lowering its drug costs since the Transparent Drug System for Patients Act (TDSPA) was introduced, by reducing markups, limiting generic prices to 50 percent of branded, and tendering generic drugs and pocketing rebates. The bad news is that it’s only getting worse for those responsible for private drug plans, as plan members continue to pay higher prices at the pharmacy. Private plan sponsors need to understand that drug pricing issues are going to be enormously important in managing costs moving forward, and must educate themselves as to how they can participate in the solution rather than be victimized by the problem. Source: "The Financial Fallout of Bill 102 on Private Sector Drug Plans," Mike Sullivan, posted at www.benefitscanada.com, Feb. 23, 2009.

Health Council website to facilitate discussion
The Health Council of Canada has launched a new website www.CanadaValuesHealth.ca to provide a forum for individuals, groups and organizations to speak out on the subject of value for money in health care. Designed to engage national dialogue, site content will be generated by participants through a message board, podcasts, blogs, online polls, and research and position papers prepared by stakeholders and interested parties. "Contrary to popular belief, aging and population growth are not the major causes of the rise in Canada’s healthcare spending," says the Council. "In reality, half of the increase can be directly attributed to accelerating use of the system. We have to understand why, question whether we are getting healthier as a result, and come up with new ideas for improving efficiency." Source: "Speaking out about healthcare value," news brief posted at www.chmonline.ca, Feb. 23, 2009.

Consumer survey supports greater role for pharmacists
A new Ipsos Reid survey, conducted on behalf of the Ontario Pharmacists’ Association (OPA), reveals that a majority of Ontarians (71%) believe pharmacists could do more to help them manage their health. More specifically, the respondents said they would depend on pharmacists for providing appropriate medication/advice for minor ailments (89%), adjusting medication formats (84%) and extending prescription refills (67%). The OPA hopes these survey results will help support their case for expanding the pharmacist’s role in Ontario. Source: "Most Ontarians say pharmacists could play greater role," Brett Ruffell, posted at www.pharmacygateway.ca, March 2, 2009.

Online workplace wellness toolkit
Employers nationwide could benefit from a workplace wellness kit and implementation guide, recently launched by the New Brunswick Business Council. The initiative came out of a working partnership between the Heart and Stroke Foundation of New Brunswick, the College of Psychologists and the New Brunswick Department of Wellness, Culture and Sport. As well as focusing on four pillars of wellness (healthy eating, physical activity, tobacco-free living and psychological wellness) the tool kit offers a four-step approach for building an effective business case. The resource is available for free, at: http://www.heartandstroke.nb.ca/site/c.kpIPKZOyFkG/b.4835889/k.95A2/Workplace_Wellness_Toolkit.htm. Source: "Workplace wellness kit launched in N.B.," Sheryl Smolkin, Employee Benefit News Canada, Jan/Feb 2009, p. 13.

Study shows therapeutic substitution adds costs
Although British Columbia’s therapeutic substitution policy was expected to save money for the provincial government, a study analyzing the B.C. Ministry of Health Services’ database from 2003 to 2005 found instead that the policy cost more than $43.5 million and had a negative impact on patients’ quality of life. The study, published in Alimentary Pharmacology & Therapeutics and co-authored by Gail Attara, executive director of The Canadian Society of Intestinal Research, and Dr. James Gray, clinical gastroenerologist and associate professor at the University of B.C., attributes higher costs to additional physician services, more hospital services and higher utilization of proton pump inhibitors. The B.C. government disputes the study findings, stating that it "conservatively estimates that we saved over $22 million." Source: "Therapeutic substitution policy costs B.C. $43.5 million: study," Stephanie Cunningham, posted at www.pharmacygateway.ca, Jan. 29, 2009.

Hewitt opens onsite wellness centre and pharmacy
Employees at Hewitt Associates headquarters in Lincolnshire, Ill., now have access to a number of onsite medical services including health screenings, lab tests, immunizations and allergy shots, and comprehensive health exams. The Choose Health Wellness Centre also features a pharmacy where employees can fill scripts and purchase over-the-counter medications and supplies. Convenient, cost-effective medical and prescription services are intended to help employees improve their health and better manage their own healthcare costs, says Tracy Keogh, senior vice-president, HR, at Hewitt. Source: "Hewitt Opens New Wellness Program Centre," posted at www.benefitscanada.com, Jan. 22, 2009.

Health Council urges action on NPS
The Health Council of Canada’s report, National Pharmaceuticals Strategy: A Prescription Unfilled, highlights gaps between promises made when the strategy was established in 2004 and progress made since then. Released in January 2009, the report reviews the status of initiatives such as catastrophic drug coverage, expensive drugs for rare diseases, breakthrough drugs, pricing and purchasing, analyzing costs, influencing prescribing, e-prescribing, common national drug formulary and real-world drug safety and effectiveness. The report is available for download at www.healthcouncilcanada.ca/docs/rpts/2009/HCC_NPS_StatusReport_web.pdf.

Infoway gets cash injection
The federal budget announced on February 27 included a $500 million cash injection for Canada’s effort to implement electronic health records (EHR) across the country. The money was earmarked for Canada Health Infoway, an independent, not-for-profit organization established by the federal government to work toward the ultimate goal of providing every Canadian with an EHR by 2016. The announcement brings the government’s total investment toward the national EHR system to $2.1 billion. Infoway says it is still $7.9 billion short of the total funding it needs to reach its overall objective. Richard Alvarez, president and CEO of Infoway, doesn’t expect the cash to flow until the new fiscal year starts in April, but he estimates the funds will create 7,500 jobs over the next two years. Alvarez says boosting EHR systems will have a lasting affect on pharmacies. "Not only will it make them more efficient, it will very much make them part and parcel of an integrated care team." Source: "Federal budget includes millions for e-health records," Brett Ruffell, posted at www.pharmacygateway.ca, Jan. 29, 2009.

Pharmacists expanding role across country
Pharmacists are taking on an expanded role in managing drug therapy in a growing number of provinces. In October 2008, New Brunswick pharmacists gained the authority to perform continued-care prescribing, to issue new prescriptions for pre-existing conditions in emergency situations and to alter scripts to accommodate special needs. Other Atlantic provinces have similar changes in the works. Beginning in January 2009, British Columbia pharmacists will have the authority to adapt certain existing scripts. Meanwhile, Ontario’s Health Professions Regulatory Advisory Council has recommended that pharmacists in the province take on a prescribing role. Source: "Patients embrace pharmacists’ new role," Alison DeLory; "HPRAC recommends expanded scope for pharmacists," Sonya Felix; and "Expanded scope puts pharmacy in spotlight," Stephanie Cunningham, Drugstore Canada, December/January 2009.