Pillcheck programs in disability and health benefits

More and more Canadians are using prescription drugs for chronic diseases and mental health problems, which drive the costs of drugs and disability benefits. At the same time, drugs don’t always work as expected for everyone. When an employee is unwell, their decreased performance can lead to additional workload for other employees, missed deadlines, and increased stress, affecting the entire team’s productivity.

Over 99% of Canadians have genetic variations that affect how their body responds to medications. Finding the right medication in the correct dosage can be expensive, time-consuming, and potentially risky.

The risks of trial-and-error prescribing

A standard trial-and-error prescribing approach may lead to high rates of insufficient medication response, use of multiple medications and drug-induced side effects and complications.

Pharmacogenetics-guided prescribing reduces the guesswork for prescriptions

Access to Pillcheck helps people manage their health conditions by matching medicines to a person’s unique metabolic profile. This personalized approach significantly reduces suffering, lost productivity, and time off work.

Five ways Pillcheck helps save on plan costs

Pillcheck offers pharmacogenetics-guided medication management programs in the workplace. Once the Pillcheck benefit is made available to plan members as a voluntary option, it helps plan sponsors save money in five areas.

1. Drug plan and health benefits costs

Drug therapy guided by Pillcheck can save between $350 and $5000 per patient (PDF), depending on the diagnosis. Savings come from avoiding the purchase of drugs that will not work and achieving remission sooner, potentially with fewer talk therapy sessions (more on that in #3 below). A recent analysis of PGx-guided prescribing for mental health showed that including pharmacogenetics is cost-saving. At an average PGx test price of $595, the payback period is under 24 months in Canada. Pillcheck’s contract pricing falls below this threshold, making it an ideal choice for plans concerned with employee well-being and company ROI. Many organizations, such as Canada Life, offer members access with a preferred price contract.

2. Reducing absenteeism and presenteeism

The rising costs of disability are getting a lot of attention, but it’s presenteeism that costs employers more. 80% of the economic burden of illness for organizations comes from lost productivity due to presenteeism, with the remaining 20% attributed to absenteeism. PGx testing can also benefit employees who are at work despite mental health issues and are not responding to medication. Pillcheck testing can shorten the process of finding the optimal medication and dosage, helping employees feel better sooner, improving productivity, and reducing the risk of disability absence. Employees can cover Pillcheck costs through Health Spending Accounts (HSA), Personal Wellness, or Extended Health Benefits (EHB).

3. Short-term disability costs

Healthcare providers are two times more efficient in identifying and correcting drug therapy problems with Pillcheck insights than without. The Pillcheck-guided medication review identified double (2x) the number of drug therapy problems compared to standard pharmacist assessment.

Best practices for psychiatry recommend optimizing medications (with the help of pharmacogenetics) before referring to counselling. This approach increases recovery rates, reduces the number of counselling sessions, and reduces the risk of relapse. Clinical trials show that PGx-guided prescribing can accelerate recovery by 8-12 weeks.

4. Reduce recruiting costs through better retention

Finding and retaining talented employees is difficult in today’s market. According to a 2019 study published in the Harvard Business Review, 34% of survey respondents left a job, either voluntarily or involuntarily, due to mental health reasons. This percentage rose to 50% for millennials and 75% for Generation Z. Additionally, 20% of all respondents had voluntarily left a job for mental health reasons. Employers can potentially reduce turnover and save on recruiting costs by assisting plan members who require medication in obtaining the right prescription.

Because a person’s DNA does not change, Pillcheck is a once-in-a-lifetime health benefit that helps plan members make informed decisions whenever prescriptions are needed. The report is updated for free every year as new evidence for existing medications and information on new ones becomes available.

Pillcheck covers close to 80% of all prescriptions for a wide variety of medical conditions. More drugs are added every year:

5. Long-term disability costs

By establishing the right drug in the right dose sooner rather than later, the goal is for people to feel better and return to work—avoiding LTD altogether or reducing duration. An independent randomized clinical trial evaluated Pillcheck’s impact. It showed that Pillcheck analysis helps accelerate recovery from depression and anxiety by 9-13 weeks. No other provider in Canada has demonstrated an impact like this.

Leading disability providers, including Canada Life, Medavie Blue Cross, Empire Life and many others, automatically include Pillcheck coverage in disability benefits.  The Pillcheck service is voluntary and helps motivated claimants to return to work faster.

Summary

• HR professionals and benefits advisors can help employers enhance the value of health benefits by adding a Pillcheck program to any benefits package.
• Pillcheck is a non-recurring paramedical benefit utilized by eligible plan members seeking better treatment to successfully manage their health conditions. By helping plan members get the right prescription, plan sponsors and their plan members benefit.
• Pillcheck programs for the workplace are engineered to enable the plan administrator to manage utilization and measure impact based on aggregated and anonymized analytics.

If you would like to find more information on Pillcheck in health benefits, please get in touch with us at [email protected]