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Twenty percent of claimants account for 80 % of the costs in insurance medicine



May 18, 2018 09:45

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Provide support to the participants assurance collective suffering of chronic diseases is key to ensuring the viability of the plans, according to a report ofExpress Scripts Canada.

Members with chronic illnesses, expensive count for 20% of claimants. However, these represent nearly 80 % of the cost of the plan and annually spend 15 times more than the other applicants, the report said.

Drugs specialty

The spending plans in the private sector increased by 2.5 % between 2016 and 2017, reveal the data of Express Scripts Canada. The expenditure on medicines specialty continued to rise, so that these drugs account for 31 % of the total expenditure of the schemes, prescription, up from 15 % in 2008.

“This trend shows no sign of slowing down, while drugs specialty make up the majority of new drugs at the stage of development and approval,” the report says.

Members with chronic health problems and costly, ” have, on average, 7.8 and chronic diseases, see of 3.3 doctors and take 8,9 medication. It is understandable that they may have difficulty with the complexity of their treatments. “

A deviation in the adherence to the treatment

Approximately half of these members do not take one or more of their medications, and the difference in the adherence to the treatment “can potentially lead to health complications and, ultimately, increase the costs of the drug insurance plan,” the report warns.

“Year after year, we see increases in spending plans in order, says Mike Biskey, president of Express Scripts Canada. And the majority of these costs are concentrated in a relatively small number of participants. It is clear that there is an opportunity to improve the health and financial results if we mobilize and guide actively this group, and we can do this with plans, fully managed. “

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