Perception vs. Reality: Vaccines and Drug Plan Design. GlaxoSmithKline Canada Inc.

Transcription

1 Perception vs. Reality: Vaccines and Drug Plan Design DATE HERE GlaxoSmithKline Canada Inc. Global Pharmaceutical & Vaccines Manufacturer World s largest supplier of Vaccines Only company in Canada that offers a solution for every vaccine preventable disease In Canada >50% of all vaccines are provided by GSK 2 1

2 The Value of Vaccinations Immunization is responsible for saving more lives in Canada than any other health intervention in the past 50 years. 1 Immunization saves 3 million lives each year, the single greatest public health achievement of all time according to the WHO. 2 1 Canadian Immunization Guide, 7 th ed., Public Health Agency of Canada 2 The Value of Immunization in the Future of Canada s Health System, Canadian Public Health Association 3 Vaccine Coverage Lower Than Expected Source: TELUS Health Employer Database, reflecting 2011 plan designs. 4 2

3 Methodology Online survey May-June 2012 Across Canada 15 Insurance Companies 211 Plan Sponsors 55 Benefits Consultants 15 Group Insurers 5 The Knowledge Gap: Vaccine Coverage Proportion of organizations that provide vaccine coverage: 68% according to plan sponsors 45% according to the AMC Employer Database OVERESTIMATION? 23% of plan sponsors think they have coverage that they may not have I wish I knew more about vaccine coverage 53% 15% Plan Sponsors want to know more Agree Disagree 6 3

4 The Knowledge Gap: Coverage & Costs 96% 96% Of plan sponsors with coverage did not know the cost of vaccine coverage or the cost of vaccines as part of their overall budget 28% 96% Of plan sponsors whose organizations do not include vaccine coverage in their health benefit plans indicate that this is because they hadn t even thought about it or didn t know it was offered. Cost was a secondary concern 7 Average Vaccine Costs GlaxoSmithKline spent $11.33 on vaccines (per covered life) in2011 High awareness/acceptance Comprehensive coverage for all vaccines Average total $ reimbursed for vaccines of any type for all GSK Canada employees and dependants in 2011 Canadian Private Drug Plans spent $7.44 (per covered life) on vaccines in 2011 Based on IMS/Brogan private vaccine sales data for 2011 adjusted for cash payers and averaged over total number of covered lives in

5 Vaccine Coverage is Worth the Cost Plan sponsors whose organization offers vaccine coverage: Offering vaccine coverage to my employees in our health benefits plan is worth the price. 87% The cost of vaccine coverage is reasonable. 77% 4% 11% Agree Disagree Agree Disagree 9 The Knowledge Gap: Useage 53% of all respondents believe the dosage for most vaccines is a single lifetime course, not a yearly injection like the flu vaccine 43% Of plan sponsors are unsure of whether there is a dollar or dosage limit to the vaccine coverage in their regular health benefit plan Average awareness vs. use of vaccine coverage in health benefits plan 49% Aware Plan sponsors estimate, 27% almost twice as many plan members are aware of vaccine coverage than those that are using it Using 10 5

6 Helping Covered Plan Members Use Their Coverage Increasing Vaccine Coverage awareness More communication 34% More written information 25% Onsite inoculations 11% Education 10% Websites 7% 11 Health Benefits Plans Migration to Wellness Based OVERALL PREVENTION AND WELLNESS IS BECOMING AGREATERFOCUSOF HEALTH BENEFITS PLANS 10% of plan sponsors indicate that their plan is focused on overall wellness 21% feel that an ideal plan should focus on overall wellness 47% of plan sponsors indicate that their plan entails a mixed approach of treatment and overall wellness 75% of plan sponsors felt that an ideal plan should involve a mixed approach THE #1 REASON FOR VACCINE COVERAGE IN HEALTH BENEFITS PLAN IS AS A PART OF OVERALL WELLNESS STRATEGY TOP 3 ADVANTAGES FROM ADDING VACCINE COVERAGE Better health protection 1 and prevention 29% 1 Less sick time 2 3 Employee appreciation/satisfaction 25% % 25% 12 6

7 Covering the Non-Covered What would change your mind about offering vaccine coverage to your employees? If government did not cover cost and the cost of the health plan did not go up too much. Yes - would need to understand the overall cost of this. I thought all vaccines were covered under the gov't program. 23% 53% Of plan sponsors think they have coverage that they may not have Of non vaccine covered plan sponsors would have included it if it had been offered I think it's paid for by Provincial Gov't. Generally Recommend Including Vaccine Coverage 69% of Consultants 34% of Insurers 13 Vaccine Coverage by Government Publicly Funded Immunization Programs (usually for infants, children and adolescents) 1 Diphtheria, Tetanus and Acellular Pertussis Inactivated Poliovirus (DTaP IPV) 2 Haemophilusinfluenzaetype i b (Hib) 3 Pneumococcal Conjugate 13 valent(pneu C 13) 4 Rotavirus ORAL (Rot 1) 5 Meningococcal Conjugate C (Men C C) 6 Measles, Mumps, Rubella (MMR) 7 Varicella (Var) 8 Measles, Mumps, Rubella, Varicella (MMRV) 9 Meningococcal Conjugate ACYW 135 (Men C ACYW) 10 Hepatitis B (HB) 11 Human Papillomavirus (HPV 4) 12 Diphtheria, Tetanus and Acellular Pertussis (Tdap)/Inactivated Poliovirus (IPV) 13 Seasonal Influenza (Inf) Note: varies by province, age, at risk, etc 14 7

8 PHAC Recommended Vaccinations for Adults (Most Not Covered by Governments) Recommended for All Adults: Tetanus, Diptheria, Pertusis Measels, Mumps, Rubella Varicella Recommended for certain At Risk Populations: Influenza Pneumococcal polysaccharide Hepatitis A & Hepatitis B Bacille Calmette- Guérin (BCG) Cholera Japanese encephalitis Poliomyelitis Meningococcal conjugate Meningococcal polysaccharide Rabies Typhoid Yellow fever Smallpox Recommended for Travelers: Unique combinations of the above vaccines based on risks endemic to the travel destination Full schedule of recommendations available at: 15 Steps To Include In Plan Availability Knowledge Low Cost High Value 53% Of non vaccine covered plan sponsors would have included it if it had been offered 69% of Consultants generally recommend including vaccine coverage 34% of Insurers Need to understand costs/determine if effective 28% More information about coverage 18% 46% of non vaccine covered plan sponsors seek either a greater understanding or more information in order to change their minds Low Cost Per Employee Disease Prevention Peace of Mind 16 8

9 Key Take Aways Wellness Based Low Cost Benefits The ideal health benefit plan is more prevention and wellness based Vaccine coverage is an important facet of an overall wellness strategy: 64% of vaccine covered plan sponsors cite wellness as a reason for vaccine coverage inclusion Vaccine coverage plan cost is not understood 87% of Vaccine covered plan sponsors believe that it is worth the price 80% would recommend it to other employers 77% believe that the cost is reasonable Over half of Non-vaccine covered plan sponsors say they would have included it if it had been offered Top mentions of vaccine covered plan sponsors advantages of vaccine coverage: Better health protection/ prevention, Less sick time Employee appreciation and satisfaction 17 Thank you! 18 9

10 Executive Summary Nearly half of health benefit plans are primarily focused on a mixed approach of treatment and overall wellness while 31% are focused specifically on treatment and only 1 in 10 are focused specifically on overall wellness When asked what the ideal health benefit plan should focus on, the distribution skewed towards prevention and wellness and mixed approaches favoured by 21% and 75% of plan sponsors respectively. Only 2% favoured a focus on treatment Vaccine coverage is an important facet of an overall wellness strategy: 64% of respondents whose health benefit plans offer vaccine coverage say that it is included for this reason About ¼ of plan sponsors with vaccine coverage cite better health protection ti prevention, less sick time and employee appreciation and satisfaction as advantages of vaccine coverage Vaccine coverage plan cost is not understood. Vaccine coverage already benefits from a high receptivity among nonvaccine covered plan sponsors with over half claiming that they would have included it if it had been offered 19 Executive Summary (cont d) More communication and written information make up the leading methods to increasing awareness of vaccine coverage Overall, sponsors who have vaccine coverage included in their plans are pleased with its inclusion: 87% believe that it is worth the price, 80% would recommend it to other employers ers and 77% believe e that the cost is reasonable Concerning vaccine coverage, there is a significant lack of knowledge, with 53% of plan sponsors wishing they knew more. Regarding use of the coverage, covered plan sponsors estimate that half of their members are aware of the coverage ; and another about half of those are using the benefits There is a disconnect between perceptions and the reality of vaccine coverage: As about a quarter of plan sponsors overestimate that they are covered 20 10