By sharing the insured cost of reimbursing repeating high and very high cost drugs of employees who’s employers have fully insured drug coverage plans, the member companies help maintain the viability of the insurance programs their employees belong to. In so doing, they allow the employees’ drug coverage to continue so that their treatments can continue.
The drug treatments covered by an employer’s insurance are often life changing and even life sustaining for the Canadian’s who need them. Without the sharing of the drug costs over ongoing threshold annually, the related costs for these drugs would result in very material increases to insurance plans when they renew annually. The price increases, in many instances could render the plan unaffordable for the employee’s employer. This is especially true for employers with small and mid-size employment bases. The result could very well mean a cut back on drug coverage by the employer or elimination of drug insurance outright. This is an outcome no one wants.
While the sharing of these costs between insurers doesn’t eliminate the inflationary pressures on the drug plan, it does help maintaining the financial viability of the benefits plan for employers. Drug pooling provided by CDIPC’s member companies is not a perfect solution but it provides a means to ensure Canadians continue to be able to afford the drugs they need to thrive as both employees and members of Canadian society.