Cubic News

Industry Publications

2013 MHCSI Pharmacy Benefits Round Table

(February 2013)

It’s time to get practical. Plan sponsors need actionable advice that takes into consideration their unique employee groups. Specifically, they want to continue to provide access to the medications members need but without facing an unmanageable drug spend. By working together, the industry can build a better drug plan. So what does that look like? To offer insight,11 industry experts came together at the 5th annual MHCSI Managed Health Care Services Inc. roundtable in Toronto in December 2012. They were tasked with assessing a fictional case study of a large plan sponsor and another of a small to medium-size employer. Canadian firms of any size can use their advice—outlined in this report—to create a better drug plan Download PDF

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Win-win plan design: A case study

Benefits Canada (January 2013)

When drug plans are designed and managed properly, there is an opportunity for a win-win scenario for all key stakeholders involved. Drug plan management does not need to be a zero-sum game, as it is often portrayed. A properly designed and managed plan that benefits everyone doesn’t happen automatically, but the process of getting there is far less complicated than many plan sponsors and advisors realize. Download PDF

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Missed Understanding

Benefits Canada (January 2013)

Insurance carriers and pharmacy benefit managers (PBMs) have long observed that plan sponsors rarely request many of the products developed to help contain drug plan costs (e.g., managed formularies, tiered plan designs, enhanced prior authorization programs, therapeutic substitution initiatives). Recently, a plan sponsor with approximately 2,000 lives asked its carrier for a potential program centring around the surveillance of narcotic drug claims and was told that nobody had ever requested that before. Download PDF

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Drug plan management for the 99.4%

Benefits Canada (November 2012)

I can understand if the average Canadian plan sponsor has grown numb to the concept of expensive biologic or “specialty” drugs. The topic of specialty drugs still dominates industry discussions, yet very little has changed in terms of the management of these claims. It’s as though specialty drugs have given the industry a vacation from focusing on boring traditional drug plan design in favour of having circular discussions that lead nowhere about wonderful (and expensive) innovations. Download PDF

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Strengthening the pharmacy-plan sponsor relationship

Benefits Canada (October 2012)

From a plan sponsor’s perspective, the best part of the changing economic landscape of retail pharmacy in Canada is that the timing could not be better. Employers are faced with employees treating chronic conditions with more complex medication regimens than what could ever have been imagined even 20 years ago, and pharmacies are faced with rapidly eroding profit margins—the extent of which they could never have imaged even five years ago. This is bringing together two dance partners that have historically had very little to do with each other... Download PDF

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