Do Your Drug Plans Need Cancer Future-proofing?

Staying ahead of emerging trends, particularly concerning cancer and chronic diseases and their impact on drug and disability plans, is more critical than ever. Although cancer is becoming more established and episodic, and death rates have decreased, new cases are still climbing due to a growing aging population. In the wake of COVID-19, wait times for screening and treatment have only lengthened, often impacting cancer claim severity. Cancer-related costs will likely rise as new drugs and therapies are developed. Cancer significantly affects society and the workplace, and we must take urgent action to future-proof our drug plans.

Plan sponsors can play a pivotal role in prevention and disease management. Working together, we can identify and proactively mitigate emerging threats, helping to ensure that everyone can access the care they need to stay healthy.

The high cost of cancer

Cancer drugs are among the most expensive medications on the market and pose a significant threat to drug plans. Tens or even hundreds of thousands of dollars are spent on cancer drugs annually, placing a substantial financial burden on the healthcare system, insurance providers, and individuals. Even with public or private drug plan coverage, many patients still face high out-of-pocket costs resulting in stress and anxiety and sometimes causing delays in necessary treatments.

As cancer research advances, drug plans face significant cost pressures, making it challenging to balance appropriate patient care with healthcare costs. In Canada, drug prices are regulated by the federal government through the Patented Medicine Prices Review Board (PMPRB). However, there is concern that with new, more expensive cancer drugs, these regulations will not be enough to keep prices affordable over the long term.

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Lessening cancer’s impact on your employees

The Canadian government offers various forms of financial support¹ to individuals and families dealing with cancer:

Employment insurance: If an individual needs to take time off work to care for someone with cancer or cannot work due to their cancer diagnosis, they may be eligible for employment insurance benefits
Compassionate care benefits: The government provides compassionate care benefits to individuals who need to take time off work to care for a family member who is seriously ill with a life-threatening condition, including cancer
Tax credits: The government offers various tax credits and deductions to individuals and families dealing with cancer; for example, individuals with cancer can claim medical expenses related to their treatment on their income tax return
Canada Pension Plan (CPP): Different programs are available to support people 60 – 64, and 65 years of age or older

Employers can take several steps to lessen the impact of cancer on both their employees and their benefit plans. Some of these steps might include the following:

Promoting prevention and healthy lifestyle choices. Employers can encourage prevention by creating a healthy workplace culture that enables employees to adopt and maintain behaviours that reduce their risk of cancer and other chronic diseases. For example, employers can offer various resources and activities encouraging healthy behaviours such as quitting smoking, reducing alcohol consumption, incorporating physical activity into their day, eating a healthy diet, and maintaining a healthy weight.
Providing access to preventive health care. Employers can facilitate access to preventive health care services, including cancer screenings such as mammograms, prostate exams, colonoscopies, and skin cancer screenings. Employers can also provide vaccination campaigns such as flu shots and HPV vaccines.
Educating employees. Employers can provide information on the importance of cancer prevention, warning signs, symptoms, and risk factors. They can also furnish healthy living educational modules for employees to understand healthy habits and necessary health measures.
Creating a healthy work environment. Employers can create a healthy work environment by providing access to nutritious food and snacks on-site, promoting the use of stairs and walking meetings, and ensuring safe indoor air quality.
Providing mental health support. Employers can create a healthy work environment by offering initiatives that support mental and emotional well-being, including counselling services, employee assistance programs (EAP), stress management and resilience training.
Offering flexible work arrangements. Employers can offer flexible work arrangements to employees undergoing cancer treatment, including telecommuting, flexible scheduling, and part-time work to allow employees better to balance their health needs with their job responsibilities.
Having a supportive work environment. Employers can provide a work environment that values and respects employees undergoing cancer treatment, including providing emotional support and counselling services and allowing for extended leaves of absence.
Advocating for better public coverage. Employers can advocate for a better regional range of cancer treatments and related costs. This could include lobbying the government to support more effective drug regulations and raising awareness about the financial impact of cancer on patients and their families.
Access to information and resources. Employers can provide information and resources that help employees navigate the healthcare system and make informed decisions about their care. This can include online resources, brochures, in-person support groups, and support services through an EAP.
Offering critical illness (CI) insurance voluntarily at no cost to the employer. CI provides insurance coverage for individuals who are diagnosed with a covered condition. This could help to cover income and experimental drug costs not covered by private plans or the government.