Drugs are the greatest source of benefit plan cost increases, so, employers target drugs for cost saving schemes. Even though the research shows that the primary source of skyrocketing prices is the new “me-too” drugs and not increased usage, employers usually seek solutions that download costs to plan members.
The more drug costs are passed on to individuals, the more people will face difficult, and often unpalatable, choices about whether to fill prescriptions. The consequences of not filling prescriptions or skipping doses are significant because conditions like heart disease, diabetes, and hypertension can worsen without prescribed medication.
In the end, the savings achieved by downloading costs to employees is transferred in even greater proportion to health expenditures borne by governments and taxpayers to deal with medical conditions that were poorly treated. So, employer savings in private plans can translate into increased costs for the public health system.
The major reason group benefit plans work (and the principle behind group insurance) is that healthy people help provide coverage for not so healthy people. None of us know when we might be the “not so healthy”; so paying for benefits now ensures they are available when we need them.
When employers demand cuts, our job is to make sure that cost alone is not the sole criteria. Our goal in negotiating benefits is to prevent erosion of benefits to members, minimize any negative effects, and ensure the principles of group insurance are maintained.
The options in this fact sheet can help resist employer attempts to pass on costs to our members, but CUPE will continue to pursue the bigger picture solution of a national pharmacare plan to ensure that drug costs are shared the same way as other health services.