Insurer pooling system keeps drug benefits affordable

Private insurers use sharing framework to lower drug costs for employers

Insurer pooling system keeps drug benefits affordable

Insurance News

By Duffie Osental

Private insurers were able to keep the cost of drugs down for more people last year, thanks to the sharing framework of the Canadian Drug Insurance Pooling Corporation (CDIPC).

CDIPC released data that revealed that, through its sharing framework for high-cost drugs, the private insurance industry has helped keep drug benefits affordable for more than 11,800 small and mid-size employers in 2017. This is an increase of 5.8% over 2016, and represents over 22,200 employees and their family members whose drugs costs exceeded $10,000 in 2017.

Canada’s life and health insurers use CDIPC’s sharing framework to shelter employers from the direct impacts of the costs associated with highly expensive and recurring drug treatments required by employees and their families.  While not eliminating these impacts, this approach shares the costs between employers and insurers. In doing so, the industry is helping ensure the sustainability of supplemental benefit plans for Canadians.

“These numbers clearly demonstrate that the industry’s pooling mechanism is working as it should,” said Dan Berty, executive director at CDIPC.

“But, with more expensive drugs entering the market every year, how to ensure employers can continue to afford to offer drug insurance benefits when costs are escalating at an ever-increasing rate remains our biggest challenge.”

 

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