GroupNews – August 2020
Eckler’s GroupNews monthly newsletter provides commentary on the issues affecting Canadian group benefit plans.
In this edition:
Manitoba adds drugs to pharmacare list
On July 17, 2020, the Manitoba government announced it has added 137 drugs to the Manitoba Drug Benefits Formulary. Coverage for the new drugs came into effect on July 16.
Included in the drugs added to the formulary are those used to treat some common conditions. A number of the drugs, 109 of the 137, are generic medications. Among the drugs added are:
- Akynzeo, for the prevention of acute and delayed nausea and vomiting associated with some forms of chemotherapy;
- Enstilar, for the treatment of psoriasis;
- Mezera, for the treatment of ulcerative colitis;
- Prevymis, for the treatment of cytomegalovirus infection;
- Radicava, for the treatment of amyotrophic lateral sclerosis;
- Sublocade, for the treatment of opioid use disorder;
- Truxima, a biosimilar for the treatment of rheumatoid arthritis; and
- Velphoro, for the control of serum phosphorus levels in patients with end-stage renal disease.
Impact: All residents of Manitoba are eligible for the provincial pharmacare program. Individuals pay an annual deductible based on adjusted total family income. Pharmacare coverage begins after the deductible is met. As the program is first payer, this is expected to have a positive impact on private plans that previously paid for these drugs.
British Columbia announces financial support and expanded drug coverage for ALS patients
The government of British Columbia has announced it has provided
$1 million to support patients living with ALS throughout the province which matches the $1 million raised by the ALS Society of British Columbia. The funds will be used to develop an ALS centre of excellence in Vancouver that provides services to patients through mobile clinics.
In addition to the new funding, the government announced that starting Wednesday, Aug. 19, 2020, the Ministry of Health will provide coverage of edaravone, or Radicava, for patients living with amyotrophic lateral sclerosis (ALS).
The list price of edaravone is approximately $120,000 per patient, per year. Coverage for edaravone is expected to benefit between 66 to 183 patients in the first year. Approximately 480 people in the province have been diagnosed with ALS.
Impact: Providing coverage for high-cost ALS drugs will help ease the burden on employee benefit plans in the province. Additional funding for resources such as mobile clinics will help reduce wait and travel times for ALS patients which could result in reduced time lost at work for both patients and their caregivers.
British Columbia introduces Economic Stabilization (COVID-19) Act
The government of British Columbia has introduced Bill 18, the Economic Stabilization (COVID-19) Act (Bill 18). Bill 18 confirms support for taxpayers from the previously announced COVID-19 Action Plan, including authorizing filing and payment deferrals for employer health tax payments to September 30, 2020.
The employer health tax is an annual tax on an employer’s B.C. remuneration paid to employees and former employees in a calendar year beginning on January 1, 2019. It was introduced to offset lost revenue from the government’s decision to eliminate future Medical Services Plan premiums in November 2018.
In response to the COVID-19 crisis, the government announced it has extended the employer health tax return and final payment due date for the 2019 calendar year to September 30, 2020. In addition, employers who ordinarily make instalment payments of their employer health tax will not be required to do so until at least September 30, 2020, with further instalment payments to be determined at a later date.
Impact: The uncertainty surrounding COVID-19 and its effect on businesses has prompted governmental efforts to provide some relief to employers. Allowing employers to delay payments to the employer health tax may allow businesses to keep employees employed longer, provide a way for employers to stay in business, or enable employers to avoid making difficult choices regarding funding for employee benefit plans.
CIHI releases report on wait times for priority procedures in Canada
On July 9, 2020, the Canadian Institute for Health Information (CIHI) released a report on wait times for surgeries and other procedures across Canada. The
Wait Times tool provides details on the amount of time patients must wait for several common procedures, including hip or knee replacement surgery, hip fracture repair, cataract surgery, and diagnostic imagery. The tool tracks the number of patients who received the required care within the medically recommended wait times for each province.
Key findings from the report include:
- Delays in wait times for hip or knee replacement and cataract surgeries resulted in approximately 30% of all patients having procedures performed past the recommended wait time;
- Wait times for procedures such as knee and hip replacement surgery vary greatly from province to province;
- Despite more surgeries being performed across Canada, many provinces have seen increases in wait times for joint replacement and cataract surgery;
- Most Canadians receive care for urgent procedures such as hip fracture repair and radiation therapy within benchmark time frames; and
- Median wait times for prostate cancer surgery and lung cancer surgery have increased by an average of three days since 2017.
Impact: The delays in wait times for procedures can prevent plan members from returning to work in a timely manner, and can have a consequential effect on follow-up doctors’ appointments, potential needed therapy for recovery, and time off work. The data and findings in the Report reflect the most recent information available from the 2019 data cycle before the COVID-19 pandemic. Post-pandemic data will likely confirm longer delays for both priority and non-urgent procedures.
This publication has been prepared by the GroupNews editorial board for general information and does not constitute professional advice. The information contained herein is based on currently available sources and analysis. The data used may be from third-party sources that Eckler has not independently verified, validated, or audited. They make no representations or warranties with respect to the accuracy of the information, nor whether it is suitable for the purposes to which it is put by users. The information is not intended to be taken as advice with respect to any individual situation and cannot be relied upon as such.