Jurisdiction

Prices for almost 70 generic drugs dropping 25-40%

On April 1 2018, prices for almost 70 of the most common generic drugs will drop 25-40%. These drugs include those used to treat high blood pressure, high cholesterol and depression – and are used collectively by millions of Canadians.

The discounts are based on an agreement between the pan-Canadian Pharmaceutical Alliance (pCPA) – which represents provinces, territories and federal government and the Canadian Generic Pharmaceutical Association (CGPA). Under the new agreement, provincial and territorial governments agreed not to pursue tendering for participating drug plans over the five-year term.

Discounts apply to both public and private plans

Canadians taking any of these drugs stand to save money – whether it’s through a public drug plan, an employee benefit plan or when they foot the cost themselves.

With the reduction in generic drug costs, private drug plans with generic substitution can expect to see greater savings for both the plan sponsor and their members. Plans with generic substitution reimburse based on the lowest priced generic drug.

BC PharmaCare launches Biosimilars initiative

Patients taking one of the following biologic drugs will have to switch to a biosimilar by November 25, 2019, if they want to continue being covered by the provincial Pharmacare program. Pharmacare will continue to pay for the biologic through the transition period. As of November 26th, Pharmacare recipients will only be eligible for the biosimilars.

BC PharmaCare launches Biosimilars initiative
Drug Originator Biosimilar Indicationss Affected
etanercept Enbrel® Benzys® Ankylosing Spondylitis
Rheumatoid Arthritis
ErelziTM Ankylosing Spondylitis
Psoriatic Arthritis
Rheumatoid Arthritis
infliximab Remicade® Inflectra®
Renflexis®
Ankylosing Spondylitis
Plaque Psoriasis
Psoriatic Arthritis
Rheumatoid Arthritis
insulin glargine Lantus® Basaglar® Diabetes (Type 1 and 2)

For additional information on this initiative visit Pharmacare Biosimilars Initiative for Patients.

If you have any questions, contact your Manulife representative.

British Columbia Budget 2018

On February 20th, Carole James, Minister of Finance for British Columbia, announced the 2018 budget for the province.

Here are a few highlights that may affect Manulife Group Benefits. The BC government will:

  1. Eliminate Medical Services Plan (MSP) premiums by January 1, 2020
    • Eliminating MSP premiums means that families will save up to $1,800 per year, and individuals will save up to $900 per year.
    • BC is the only province where residents pay this fee.
  2. Invest $105 million in Fair PharmaCare to expand coverage for 240,000 families starting January 1, 2019
    • Fair Pharmacare deductibles will be reduced for families with a household net income between $30,000 and $45,000
    • Fair Pharmacare deductibles will be eliminated for families with a household net income between $15,000 and $30,000
  3. Introduce an employer health tax to help fund the elimination of MPS premiums
    • Businesses with payrolls over $1.5 million will pay the full rate of 1.95%
    • Businesses with payrolls between $500,000 and $1.5 million will benefit from a reduced rate
    • Businesses with payrolls of less than $500,000 will not pay any employer health tax

British Columbia (BC) Medical Services Plan premiums dropping January 1, 2018

As of January 1, 2018, the BC Medical Services Plan (MSP) premiums will drop by 50% for all British Columbians. The BC government is hoping to eliminate these premiums over the next four years.

Currently, under the BC Medicare Protection Act, all residents of BC must enrol in the MSP. Once enrolled, they can pay their MSP premiums through:

  • self-administered accounts or,
  • through their employer under a MSP Group Plan in either one of the following ways:
    • The employer deducts premiums from the employees wages and remits them to the government.
    • The employer pays premiums on behalf of their employees as a taxable benefit.

For more information on the changes to the MSP premiums, visit the BC governement MSP site.

The Ontario government is making changes to OHIP+ starting April 1, 2019

Starting April 1, 2019, OHIP+ will no longer cover individuals 24 years old and under with drug coverage through a private insurance plan.

You can see the official announcement from the Ontario government as well as their FAQs for Patients.

If you have any questions, contact your Manulife representative.

Quebec RAMQ out of pocket maximum and coinsurance effective January 1, 2021

Plan sponsors with plan members who reside in Quebec must offer prescription drug coverage that meets the minimum legislative requirements set by the Régie de l’assurance maladie du Québec (RAMQ).

On January 1, 2021, the following changes were applied to private plans as announced by RAMQ:

The maximum annual out-of-pocket drug expenses that plan members are required to pay will remain at $1,144.00.

The plan member’s co-insurance level (maximum out-of-pocket expenses) changed from 37% to 35% of the prescription cost.

The maximum coverage for Quebec smoking cessation products stayed at $800.

Bill 28 (2015) update – Quebec adds new pharmacy services

Since June 20, 2015, Quebec pharmacists have been able to bill private plans for four professional services to their patients because of Quebec’s Bill 28.

On August 29, 2018, the Minister of Health and Social Services, Quebec, reached an agreement with the Association Québécoise des Pharmaciens Propriétaires (AQPP) that allows pharmacists in Quebec to perform three new professional services.

Effective date October 31, 2018 plan sponsors providing drug coverage to their plan members in Quebec are required to reimburse these services:

  1. Administration of a drug for teaching purposes. This means the pharmacist demonstrates to the patient* the proper self-administration of an injectable drug, including subcutaneous (into the fat layer under the skin), intradermal (into the layer under the skin), or intramuscular (into the muscle). This service is limited to one per year per insured person and per prescribed drug. *The “patient” is either the plan member or the plan member’s dependent.
  2. Substitute a prescription drug when there is a supply shortage of the prescribed medication in Quebec. First, the pharmacist must confirm that the prescribed drug is not available in two other pharmacies and two other wholesalers, and that the Régie has not proposed a replacement drug; then the pharmacist can substitute an alternative drug from the same therapeutic class. This service is limited to one per supply shortage period provided treatment is continued with the alternative drug.
  3. Adjust a new prescription (shape, quantity or dosage) for patient safety to:
    • reduce the side effects related to a drug
    • manage drug interactions
    • prevent organ failure
    • treat appropriately according to the patient’s hepatic/renal clearance
    • provide a dose appropriate to the patient’s weight
    • improve tolerability
    • correct a dosage mistake

Adjustment listed below are not eligible for reimbursement:

  • the drug form (e.g., switching from an oral solution to chewable tablets), or
  • the quantity dispensed, or
  • the dosage frequency without altering the original total daily dose

If you have questions, contact your Manulife Representative.

Quebec RAMQ out-of-pocket maximum increases

Plan sponsors with plan members who reside in Quebec must offer prescription drug coverage that meets the minimum legislative requirements set by the Régie de l’assurance maladie du Québec (RAMQ).

On July 1, 2018, the following changes were applied to private plans as announced by RAMQ:

  • The maximum annual out-of-pocket drug expenses that plan members are required to pay increased from $1,066 to $1,087.
  • The plan member’s co-insurance level (maximum out-of-pocket expenses) increased from 34.8% to 34.9% of the prescription cost.

On January 1, 2019, the maximum coverage for Quebec smoking cessation products will increase from $700 to $800.

Quebec's drug plan legislation requires that private drug plans are at a minimum equal to the drug coverage provided by the RAMQ. As such, all drug plans covering Quebec plan members must provide coverage for smoking cessation products that are listed on the RAMQ Formulary.