Weight loss drugs have remained the headlines for most of 2023 due to their impact on diseases like obesity and diabetes. We asked Barbara A. Martinez, National Practice Leader, Drug Solutions at Canada Life to share her insights on benefit trends, GLP-1 drug management and how plan sponsors can prepare for the future.

A lot of plan sponsors are wondering about the impact of inflation on their benefits plans. Should they be concerned?

In 2022, Canada Life surveyed almost 13,000 plan members and found 64% of all respondents fell within moderate to high risk for financial issues. Specifically:

• 24% are just getting by financially
• 28% are worried they won’t have enough for their future
• 23% say their finances are controlling their lives.

Today, we look more closely at how financial health contributes to medical conditions and disabilities. This allows us to develop or promote tools and resources for plan members to help with financial stress—things like credit counselling programs, student debt savings programs, registered education savings programs and estate assistance programs. Years ago, who would have thought that these kinds of financial support programs would be available to positively impact health and productivity?

New drugs and therapies, such as Ozempic, can provide major improvements to quality of life, but they come with a high price tag. What can plan sponsors do to ensure they’re providing access to needed drugs while also managing plan costs?

This question is what keeps me up at night! How can we help plan sponsors balance the difficult task of managing costs while delivering access to needed medicines?

The answer is for plan sponsors to fully understand what their drug plan is intended to do for their organization and their members. In other words, what are the drug plan philosophy, goals and objectives? For example, is it meant to attract new talent in a competitive labour environment? Keep top performers invested by adding value to their overall compensation? Promote the financial, physical and mental well-being of employees so they can stay productive? Manage spending by sharing costs with members? Once plan sponsors understand what their drug plan is meant to do for them, they can put together a strategy to meet those objectives.

Carriers need to offer a wide variety of design elements to fit all types of plans and plan sponsor approaches to drug plans. Prior authorization is one strategy to ensure drug coverages are deployed appropriately. Prior authorization is intended to help ensure that a drug represents reasonable treatment before coverage is provided. In this world of high cost and high impact drugs, it’s a core element of drug plan design that should be in place for most plans.

What is one thing plan sponsors can do now to prepare for the developments and trends of the next five years?

The industry has evolved to consider the mind-body-work connection as the link between financial, physical and mental well-being. We recognize how closely these are tied together and work to advance benefits design to meet the new norms.

Diversity, equity and inclusion (DEI) is at the forefront, and that includes gender affirmation products that we didn’t have in the past. Looking ahead, we’re investigating family building supports, such as coverage for surrogacy and adoption expenses, and coverage for traditional Indigenous wellness and healing supports.

It’s quite remarkable how far we have come to meet these previously unmet needs. But it doesn’t always mean we need a new kind of coverage or product—Even a non-taxable health spending account can meet an incredibly diverse set of needs.

One thing plan sponsors need to do to prepare for the future is to understand their members’ unmet needs. Getting that insight sets them up to find ways to help through their benefits programs.