The Value of Specialty Medications: An Employer Perspective

The Conference Board of Canada, 102 pages, September 8, 2016
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This report provides a quantitative cost-benefit analysis of the use of specialty medications in treating three chronic diseases (rheumatoid arthritis, Crohn’s disease, and multiple sclerosis) for employees and their dependants.

Document Highlights

Specialty medications are currently used to treat a widening array of chronic conditions. From an employer’s perspective, this has raised concerns about how to manage the rising costs of employer-sponsored health benefits due to the increased use of these specialty medications by physicians. However, it is important that employers recognize both the costs and benefits associated with specialty medications for employees and their dependants.

This report provides a quantitative cost-benefit analysis of the use of specialty medications in treating three chronic diseases: rheumatoid arthritis, Crohn’s disease, and multiple sclerosis. The modelled results generate the costs and benefits from three different perspectives—the perspective of the plan-sponsoring employer; the broader corporate perspective; and the societal perspective. The findings suggest that the benefits from employer-provided specialty medications are real, and extend well beyond the workplace of the beneficiary receiving treatment. They include benefits to other companies related to reduced caregiving needs of treated dependants, as well as the reduced use of both in-patient and out-patient health care resources.

Table of Contents

EXECUTIVE SUMMARY

Chapter 1 Introduction

Chapter 2 How Specialty Medications Benefit Employees

  • The Effect of Multiple Sclerosis on Employees or Their Dependants
  • The Effect of Specialty Medication Treatment on Multiple Sclerosis
  • The Effect of Crohn’s Disease on Employees or Their Dependants
  • The Effect of Specialty Medication Treatment on Crohn’s Disease
  • The Effect of Rheumatoid Arthritis on Employees or Their Dependants
  • The Effect of Specialty Medication Treatment on Rheumatoid Arthritis

Chapter 3 Costs and Benefits of Funding Specialty Medications From an Employer Perspective

  • Cost of Specialty Medications
  • Employer Costs Associated With Specialty Medications in the Treatment of Multiple Sclerosis
  • Employer Benefits Associated With Specialty Medications in the Treatment of Multiple Sclerosis
  • Employer Costs Associated With Specialty Medications in the Treatment of Crohn’s Disease
  • Employer Benefits Associated With Specialty Medications in the Treatment of Crohn’s Disease
  • Employer Costs Associated With Specialty Medications in the Treatment of Rheumatoid Arthritis
  • Employer Benefits Associated With Specialty Medications in the Treatment of Rheumatoid Arthritis

Chapter 4 Costs and Benefits of Funding Specialty Medications From a Corporate Perspective

  • Corporate Costs Associated With Specialty Medications in the Treatment of Multiple Sclerosis
  • Corporate Benefits Associated With Specialty Medications in the Treatment of Multiple Sclerosis
  • Corporate Costs Associated With Specialty Medications in the Treatment of Crohn’s Disease
  • Corporate Benefits Associated With Specialty Medications in the Treatment of Crohn’s Disease
  • Corporate Costs Associated With Specialty Medications in the Treatment of Rheumatoid Arthritis
  • Corporate Benefits Associated With Specialty Medications in the Treatment of Rheumatoid Arthritis

Chapter 5 Costs and Benefits of Funding Specialty Medications From a Societal Perspective

  • Societal Costs Associated With Specialty Medications in the Treatment of Multiple Sclerosis
  • Societal Benefits Associated With Specialty Medications in the Treatment of Multiple Sclerosis
  • Societal Costs Associated With Specialty Medications in the Treatment of Crohn’s Disease
  • Societal Benefits Associated With Specialty Medications in the Treatment of Crohn’s Disease
  • Societal Costs Associated With Specialty Medications in the Treatment of Rheumatoid Arthritis
  • Societal Benefits Associated With Specialty Medications in the Treatment of Rheumatoid Arthritis

Chapter 6 Sensitivity of Modelling Results

  • Variations in Treatment Costs
  • Variations in Wages
  • Variations in Reimbursement Proportion
  • Variations in the Cost-Sharing for Long-Term Disability Coverage

Chapter 7 Limitations

Chapter 8 Conclusions

Appendix A Bibliography

Appendix B Methodology and Assumptions

  • Overview
  • Calculation of Benefits From Treating Multiple Sclerosis
  • Calculation of Benefits From Treating Crohn’s Disease
  • Calculation of Benefits From Treating Rheumatoid Arthritis

Appendix C Specialty Medication Treatment Details

Appendix D Glossary

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