Employers continue to underestimate the prevalence of chronic disease in the workplace, according to The 2019 Sanofi Canada Healthcare Survey. Employers estimate that 39 per cent of their employees have a condition like diabetes, asthma or hypertension, when, in fact over half of the Canadian workforce (54%) is affected by chronic disease – a percentage that increases to 69 per cent among those aged 55 to 64.
This was one of several knowledge gaps the survey uncovered through interviews with more than 1,500 plan members and 403 benefit plan sponsors in January. The survey results, published in June, also revealed a divergence in health care priorities between plan sponsors and plan members and a low awareness of the differences between private and public prescription drug plans among both plan members and sponsors.
The 2019 survey is an educational and practical tool that industry stakeholders can use to gain a better understanding of health benefit perceptions and behaviours and to use those insights to make important connections and positive changes that will deliver full plan value to sponsors and their members. It is with this objective in mind that we took the opportunity to summarize the survey’s top 10 findings:
1. Chronic Disease Management – The vast majority of plan members (87%) said they would like to know more about their condition and how to treat it. A near equal number of plan sponsors (82%) would like their benefit plan to do more to support plan members with chronic conditions. Given the serious impacts of chronic disease on organizational performance and benefit plans, employers would be wise to invest in health coaching and education, as the survey advisory board recommends. Consider that for every $100 in private drug plan costs, $65 is for drugs to treat chronic diseases.1
2. Public vs. Private Drug Plans – Both plan sponsors and members inaccurately believe that private and public prescription drug costs cover close to the same number of medications. Plan members estimate that about 6,600 drugs are covered under private plans and about 6,500 are covered under public plans, similar to plan sponsors’ estimate of 7,500 and 7,200 respectively. In reality, private drug plans cover between 10,000 and 12,000 drugs. That’s at least double the number public plans cover at an average of 5,000 drugs.2
3. Health Priorities – A large majority of plan sponsors (85%) and plan members (77%) agree their workplace culture encourages health and wellness. However, there is a marked difference in their health and wellness priorities. Emotional/mental health is the top area for investment for 61 per cent of plan sponsors. On the other hand, exercise and physical activity is the number one health priority for plan members (56%). The survey’s advisory board recommends that employers place equal emphasis on all areas of wellness, given their interrelation (i.e.) unmanaged chronic disease potentially leading to depression.
4. Personalized Medicine – The survey indicates strong support for personalized medicine. Nearly three-quarters of plan members (74%) would consent to having their DNA analyzed to determine the most effective treatment for their condition, based on their genetic profile. A majority of plan sponsors (65%) are interested in providing coverage for pharmacogenetic testing.
5. Medical Cannabis – The survey reveals a similar upward trend among plan sponsors and members for medical cannabis coverage: 45 per cent of plan sponsors believe medical cannabis should be covered by health benefit plans - up from 34 per cent in 2018 – while 64 per cent of plan members agree.
6. National Pharmacare – Respondents have surprisingly little or no knowledge of the possibility of a national pharmacare program being introduced to Canada: 77 per cent of plan members and 52 per cent of plan sponsors were unaware of that a universal drug coverage plan was under consideration – results the advisory board described as a “wake-up call” in their annual report. Though awareness is low, there is a high level of support for a national pharmacare program among plan members (87%) and plan sponsors (84%).
7. Absenteeism Data – Four out of five plan sponsors (80%) would like to have more data that illustrates the rate of absenteeism in their workplace and explains the causes. Data analyses is used by 24 per cent of plan sponsors to identify the main disease states in their workforce and 26 per cent use it to make the connection between drug claims, disability claims and other health benefits.
8. Plan Member Engagement – Plan members continue to signal their openness to receiving targeted, health-related information based on their personal benefit use at 65 per cent, though confidentiality concerns among both plan members and sponsors must be addressed. The advisory board recognizes that this type of communication may be key in helping increase plan member engagement in personal health management and encouraging participation in new benefits.
9. Drug Claims – In 2018, 82 per cent of plan members submitted at least one personal claim for a prescription and 62 per cent submitted at least one for a plan dependent, with 8.8 claims on average for themselves and 7.7 for others. Plan members estimated their plan paid $2,393 for themselves (just shy of $300 per claim). Among plan sponsors, 48% are concerned that improper medication use negatively impacts the cost of their drug plan, a percentage that increases to 65 per cent in Quebec. The advisory board recommends that new approaches are needed to raise awareness about the level and effects of non-adherence.
10. Plan Awareness – Only 49 per cent of plan members were aware of changes that had been made to their health benefit plan in the past two years, compared to 75 per cent of plan sponsors. Four out of five plan members (83%) believe their employer plays a fixed cost to their plan provider, regardless of how much or little the plan is used. Nearly half (48%) believe they will continue to have access to their workplace health benefit plan after retirement. The advisory board emphasizes that as more changes to benefit plans are made or considered, it becomes even more important for plan sponsors and plan members to increase their knowledge and understanding of how benefit plans work.
Plan sponsors and advisors can draw on the survey results to inform decision making and guide strategic planning toward a healthier health benefit plan. The full report can be downloaded at www.sanofi.ca.
1 Private Plan Drug Cost Forecast (2018-2020) Innovative Medicines Canada, based on analysis by IQVIA Solutions Canada.
2 Canadian Life and Health Insurance Association data