2012 Success

• Mobile apps

• Pharmacy Network Value Plan

• ProspectsPlus

2

Agenda

• Canadian Diabetes Association Keynote Speech

• Workplace Wellness: Benefits for Any Business

• DrugSolutions: balancing health and cost management needs

• Panel Discussion with program experts

3

diabetes.ca | 1-800-BANTING (226-8464)

Diabetes in Canada A disease of pandemic proportions

Presented by Dr. Jan Hux

Canadian Diabetes Association

• Founded in 1953 by Dr. Charles Best

• Supported by a community-based network

• Creates awareness

• Provides hope and improves people’s lives; and

• Supports promising research towards finding a cure.

5

What is diabetes?

• A chronic, often debilitating and sometimes fatal disease, in which the body cannot produce insulin or cannot properly use the insulin it produces.

• Result: Elevated blood glucose levels that can lead to serious complications if not managed properly.

6

Diabetes complications

• 80% die from a heart attack or a stroke;

• 35% of new dialysis patients in 2011 had diabetes;

• 30% will become blind;

• 70% of non-traumatic limb amputations;

• 25% suffer from depression; and

• Life expectancy may be shortened by 5-15 years.

7

Diabetes: A Pandemic

• Rates in Canada almost doubled over past decade.

• Over 20 people diagnosed every hour.

• 2.7 million Canadians diagnosed with diabetes in 2010.

4.2 million by 2020

• Nearly 1,000,000 people have diabetes & don’t know it.

• 5.4 million have prediabetes.

• 1 in 4 Canadians living with diabetes or prediabetes. If

nothing is done, by 2020, it will be 1 in 3.

8

The cost of diabetes in Canada

• $11.7 billion spent in 2010, to rise to $16 billion by 2020.

• Complications from diabetes account for 80% of cost.

9

Diabetes management: a daily challenge

• Diabetes management is not just about medications/insulin and supplies

• It is a constant struggle to manage/juggle/plan and adjust medications, physical activity, etc. in order to remain healthy

10

The numbers

• Fewer than half of Canadians with type 2

diabetes are at the recommended A1C target

5.6 7.8 12.9 5.4 11.7 6.2

11

The personal price of diabetes

• Nearly 60% of Canadians say they do not comply

with their prescribed therapy because they cannot

afford it.

• Less access to public or private insurance means

greater out-of-pocket costs.

• Reaching a breaking point for those living with the

disease.

12

Why is diabetes important to consider?

• Among the top 10

causes of disability

worldwide.

• Over 50% of type 2

diabetes could be

prevented or delayed

with healthier diet &

more physical activity.

13

Diabetes in the workplace

• Investment into health and wellness programs will reduce sick leave and absenteeism & support strong plan member productivity and retention.

• Support of wellness programs makes good business sense.

14

Being part of the solution

• Provide opportunities for employee education and engagement.

• Take a holistic approach to health and wellness and develop workplace policies that promote health.

15

Questions? | Connect with us!

• diabetes.ca

• 1-800-Banting (226-8464)

@DiabetesAssoc

Facebook.com/CanadianDiabetesAssociation

16

Workplace Wellness Benefits

any Business

Driving the Wellness Agenda for

your Customers

Agenda

• Why Health & Wellness matters

• Initiating the Health & Wellness conversation

• Information gathering and resource options

• Putting a plan together

• Questions

18

Before we get started remember…..

• We are here to help

• Value added = no cost tools and resources

• You don’t have to be an expert

• You don’t have to remember all of this

• Awareness is the key

19

Diabetes Obesity

Cardiovascular Disease

Cancer

Mental Health

20

Are your customers interested in promoting a culture of wellness in their workplace? Should they be?

Workplace productivity is being impacted by: Absence of key plan members due to illness

Distracted plan members whose family members are ill

Decreased resiliency among those who have to fill in the gaps

Inability to attract and retain skilled plan members

21

Do you know what workplace wellness means to your clients?

• Decreased rate of absenteeism

• Fewer sick days

• Decreased amount of health/insurance claims

• Improvement of worker’s performance and productivity

• Lower employee turnover rate

22

Why should workplace Health & Wellness be important to you, the Advisor?

• Proactive is much more desirable than reactive

• Clients health and wellness is important to the bottom line

• Increase your ability to engage new business

• Increase your ability to retain existing business

23

The Basics: Helping your client develop a simple Health & Wellness program

Assessment Planning Implementation Evaluation

24

Key points to remember

• Don’t underestimate what your clients already have

• Help your clients gain an appreciation for where they are and where they want to go

• A comprehensive strategy may not be needed

• Take a practical approach

• Okay to start small

• Little or no budget is not a problem

25

Start at the beginning: Gathering the facts…

Utilize value added tools to help clients

Data to help clients analyze and strategize.

• GroupNet reporting

• Organizational Health Risk Assessment

• Industry specific reports

• Health and Wellness Activity Report

• Personal Health Risk Assessment Aggregate Report

26

Health & Wellness Resources What’s out there?

Providing plan members with a reliable Canadian source for health information

28

Our Health and Wellness Site

• Community Resources

• Interactive Tools

• Drug, Condition, Test/Procedure databases

• Health Features

• E Newsletter

• Reliable Canadian content built for GWL

• Helps identify health risks and build action plans

29

www.workplacestrategiesformentalhealth.com

Community health resources

30

Employee & Family Assistance Plans (EFAP)

Contact: GWL & Shepell-fgi

• First Chat

• Video-counselling

• Manager Consultations

• Proprietary secure network

31

We Need to be Serious: Why Does Mental Health Matter?

• 1 in 5 Canadians

• Co-morbidity of mental health conditions is a big issue

• 60% of disability claims have a mental health component

32

Mental Health Resources

Great-West Life Centre for Mental Health in the Workplace:

• Public domain

• Increase knowledge and awareness

• Help turn knowledge into action

• Recent accomplishments – Managing Mental Health Matters & National Standard for Psychological Safe and Healthy Workplaces

33

www.workplacestrategiesformentalhealth.com

• 2012 National Ipsos Reid Survey

on psychological health and safety in the workplace

• National Standard of Canada for Psychological Health and Safety in the Workplace

• Centre Resources target survey results and national standards

Supporting Psychological Health and Safety

34

Healthy Workplace Month

www.healthyworkplacemonth.ca

35

Key Take Aways

• We are here to help

• No cost resources and tools are available

• Communication and education is paramount

• Mental Health issues drive productivity loss, absence and disability

36

Addressing Health and Wellness is vital to you and your clients

There are tools and resources to help with:

• Asking the questions

• Gathering the information

• Putting a plan together

Be the “go to” proactive advisor for your clients

37

Thank you for your time!

Questions?

DrugSolutions From yesterday, to today,

to tomorrow…

Discussion

• Meeting your needs for your clients (Education & Cost Management)

• How is DrugSolutions working?

• What can be expected next? Why?

• Practical tips to help strengthen your advice

40

The Basis for DrugSolutions: Our Dual Bottom Line

Balancing the health needs of plan members

and

the cost management needs of plan sponsors

41

Better savings than expected

• New amendment factors, April 2013

• Conversion opportunity

LOW request for brand forms

End Result

• Material savings for plan sponsor

• Very small impacts to plan

members

Enhanced Generic Substitution

4% savings

0.4% impact

42

Health Case Management

• Savings on new claims

• Collaboration with doctors and patients on lower cost therapies

• Follow-up vs. one and done decision

25% savings

43

Average Savings from Designated Pharmacy

• Have only begun rolling out

to existing claimants

• <40% of pharmacies

manage specialty drugs

• Expanding to Prior

Authorization drugs

5% savings

Health Case Management

44

Health Case Management

Overall satisfaction with Health Case Management team “Extremely satisfied”

Personal touch makes a difference

“Overall they seem genuinely

concerned …they are sympathetic

and helping with my condition”

– A Thankful Wife:

88% “Extremely satisfied”

45

Pharmacy Network Value Plan

• Over 800 Sales as of March 2013

• Maximum Value Pricing available June 2013

46

800+ sales

Acute/Maintenance/Specialty Formulary

• Efficient use of healthcare dollars (true insurance)

• One size doesn’t fit all

• Specialty drugs aren’t a problem if there are no claims

• Problem comes with an 80% coinsurance on a $50,000 claim

47

$10K Out of Pocket

$0

Therapeutic Class Pricing

• Picking up where Health Canada left off

• Reimbursement limits for specific therapeutic classes

• Additional cost management

48

2.5% savings

Maximum Savings, Maximum Value

• 4% Enhanced Generic Substitution

• 25% Health Case Management

• Up to 15% Pharmacy Network Value Plan (Costco)

• Up to 23% Acute/Maintenance/Specialty Formulary

• 2.5% Therapeutic Class Pricing

49

Cost management is a necessity. Health management remains an opportunity.

Cost & Health – Our Dual Bottom Line

50

Diabetes Drug & Supply annual Cost = $275M*

Diabetes related cost due to lost productivity = $9.6B**

*Telus block of business **Canadian Diabetes Association, “Get Check Now” , March 2011

Employer Perspective – Health Outcomes

• Your clients understand the value of promoting and supporting health outcomes BUT

• Do they have the time?

• Do they have the expertise?

• Do they have the money?

• Do they know where to begin?

51

• Top group carrier

• Innovation leader

• Dual bottom line focus

• Top retail pharmacy brand

• Convenient & national

• Clinical service programs in Pharmacy

Supporting healthier outcomes together

Together “helping plan sponsors and plan members manage costs and improve health outcomes”

52

Two unique programs. One unique approach.

1. Diabetes Support Program

2. Medication Counselling Program

One Approach:

• Proactive plan member outreach

• Turn-key solution for the average plan sponsor

• NO cost

53

Diabetes Support Program

1. GWL writes to plan member

2. Plan member books appointment

3. Dedicated call centre team

4. Plan member visits pharmacist

5. Plan member feedback

6. Reporting

54

The plan member experience

• A1C testing

• Lifestyle counselling

• Information kit

• Follow up appts booked, as required

55

Program Goals:

• Access

• Adherence

• Education

Medication Counselling Program

56

• NOT generic substitution

• Call centre pharmacist will counsel patients on medication alternatives

• Plan member and plan sponsor savings

• Lower out of pocket cost can improve adherence

**Program only applies to existing Shoppers Drug Mart patients

Cost

• Generic substitution

• Maximize days supply dispensing

• Support medication reviews

Health

• Adherence management

• Lifestyle counselling

• Minor ailment assessment

Pharmacist & Benefit plan management

57

What you can tell your clients

58

Medical costs: two to three times higher than those without diabetes. Direct plan sponsor costs : $1,000 to $15,000 a year.

More than claims management: working to support plan members living with diabetes. Managing costs while improving health – Our dual bottom line in action!

Drug Plan Performance Report

• Putting solutions into action

• Created to present detailed drug information to clients

• Fast, easy and free

• Allows you to focus on advice

59

Drug Plan Performance Report

• Annual drug claims experience – 3 years

• Claims statistics by age

• Claims cost breakdown – ingredient cost and dispensing fee

• Brand vs. Generic drug claims

• Top therapeutic class spending

• Acute, maintenance and specialty drug spending

• Overview of drug plan design

• Plan savings – enhanced generic, dispensing fee limits, etc.

60

2013 DrugSolutions

• Diabetes Support Program – Shoppers Drug Mart

• Enhanced Prior Authorization

• Designated Pharmacy for prior authorization drugs

• Acute / Maintenance / Specialty Formulary

• Therapeutic Class Pricing Feature

• Pharmacy Network Value Plan

• Maximum Value Pricing (Costco Option 3)

• Drug Plan Performance Report

61

In Closing

• Today’s drug plans are not sustainable

• New management techniques are needed

• We support you in providing solutions to your clients

• Together we’re balancing health needs of plan members and cost needs of plan sponsors

62

Panel

• Barbara Martinez, Practice Leader, Benefits Solutions

• Tara Besant, Director, Pharmacy Benefits

• Ben Harrison, Manager, Group Strategic Relationships

• Dr. Dorian Lo, Executive Vice President, Pharmacy & Healthcare, Shoppers Drug Mart

63