12/6/2012

1

Perception vs. Reality: Vaccines and Drug Plan Design

DATE HERE

GlaxoSmithKline Canada Inc.

• Global Pharmaceutical & Vaccines Manufacturer

• World’s largest supplier of Vaccines• 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

12/6/2012

2

The Value of VaccinationsImmunization 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

hi t f ll

3

1Canadian Immunization Guide, 7th ed., Public Health Agency of Canada2The Value of Immunization in the Future of Canada’s Health System, Canadian Public Health Association

achievement of all time” according to the WHO.2

Vaccine Coverage Lower Than Expected

4

Source: TELUS Health Employer Database, reflecting 2011 plan designs.

12/6/2012

3

Methodology

Online survey Across CanadaMay-June 2012

5

15 Group Insurers

15Insurance Companies

55 Benefits Consultants211 Plan Sponsors

The Knowledge Gap: Vaccine Coverage

Proportion of organizations that provide vaccine coverage:• 68% according to plan sponsors

OVERESTIMATION? 23% of plan sponsors think they

53%

“I wish I knew more about vaccine coverage”

• 45% according to the AMC Employer Database

have coverage that they may not have

6

Agree Disagree

15% Plan Sponsors want to know more

12/6/2012

4

96%96% Of plan sponsors with coverage did not know

the cost of vaccine coverage

The Knowledge Gap: Coverage & Costs

the cost of vaccine coverageor the cost of vaccines as part of their overall budget

96%Of plan sponsors whose organizations do not

i l d i 28%

7

include vaccine coveragein 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

Average Vaccine Costs

GlaxoSmithKline spent $11.33 on vaccines (per covered life) in 2011

GlaxoSmithKline spent $11.33 on vaccines (per covered life) in 2011

•High awareness/acceptance•Comprehensive coverage for all vaccines

covered life) in 2011covered life) in 2011

Canadian Private Drug Plans spent $7.44 (per 

covered life) on vaccines in 2011

Canadian Private Drug Plans spent $7.44 (per 

covered life) on vaccines in 2011

Average total $ reimbursed for vaccines of any type for all GSK Canada employees and dependants in 2011

8

20112011

Based on IMS/Brogan private vaccine sales data for 2011 adjusted for cash payers and averaged over total number of covered lives in 2011

12/6/2012

5

Vaccine Coverage is Worth the Cost

“Offering vaccine coverage to my employees in our health benefits plan is worth the price ”

Plan sponsors whose organization offers vaccine coverage:

“The cost of vaccine coverage is reasonable.”

87%

4%

benefits plan is worth the price.77%

11%

9

Agree Disagree Agree Disagree

43% Of plan sponsors are unsure of whether there

is a dollar or dosage limit

The Knowledge Gap: Useage

53% of all respondents believe the dosage for most vaccines is a single lifetime to the vaccine coverage in

their regular health benefit plan

vaccines is a single lifetime course, not a yearly injection like the flu vaccine

49%

27%

Average awareness vs. use of vaccine coverage in health benefits plan

Plan sponsors estimate, l t t i l

10

Aware Using

27% almost twice as many plan members are aware of vaccine coverage than those that are using it

12/6/2012

6

Helping Covered Plan Members Use Their Coverage

More communication

34%Increasing Vaccine Coverage awareness

34%More written information

25%Onsite inoculations

11%Education

10%

11

10%Websites

7%

Health Benefits Plans Migration to Wellness Based

OVERALL PREVENTION AND WELLNESS IS BECOMINGA GREATER FOCUS OF HEALTH BENEFITS PLANS

Better health protection 1 2929%

TOP 3 ADVANTAGES FROMADDING VACCINE COVERAGE

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

75% of plan sponsors felt that an ideal plan should involve a mixed

h

12

1 and prevention1Less sick time2

Employee appreciation/satisfaction3

29%25%25%

29%treatment and overall wellness

approach

THE #1 REASON FOR VACCINE COVERAGE INHEALTH BENEFITS PLAN IS AS A PART OF OVERALLWELLNESS STRATEGY

12/6/2012

7

Covering the Non-Covered

“If government did not cover cost

What would change your mind about offering vaccine coverage to your employees?

23% Of plan sponsors think they have coverage g

and the cost of the health plan did not go up too much.”

“I think it's paid

“Yes - would need to understand the overall cost of this. I thought all vaccines were covered under the gov't program.”

53% Of non vaccine covered plan sponsors

would have included it if it had been offered

that they may not have

Generally Recommend

13

“I think it's paid for by Provincial Gov't.”

Generally Recommend Including Vaccine Coverage

69% of Consultants

34% of Insurers

Vaccine Coverage by GovernmentPublicly Funded Immunization Programs (usually for infants, children and adolescents)

1 Diphtheria, Tetanus and Acellular Pertussis – Inactivated Poliovirus (DTaP‐IPV)

2 H hil i fl t b (Hib)2 Haemophilus influenzae type 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)

14

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

12/6/2012

8

PHAC Recommended Vaccinations for Adults (Most Not Covered by Governments)

Recommended for All Adults:• Tetanus, Diptheria, Pertusis• Measels, Mumps, Rubella• Varicella• 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

15

g p y• 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: http://www.phac-aspc.gc.ca/im/is-cv/index-eng.php#b

Availability Knowledge Low CostHigh Value

Steps To Include In Plan

53%Of non vaccine

More information about coverage 18%

Need to understand costs/determine if

effective 28%

Of non vaccine covered plan sponsors would have included it if it had been offered

69% of Consultants generally recommend including vaccine

Low Cost Per Employee

Disease Prevention

Peace of Mind

16

46% of non vaccine covered plan sponsors seek either a greater understanding or more information in order to change their minds

coverage34% of Insurers

12/6/2012

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

•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

•Top mentions of vaccine covered plan sponsors advantages of vaccine coverage:

•Better health protection/ prevention,

•Less sick time•Employee appreciation

and satisfaction

17

ginclusion covered plan sponsors say

they would have included it if it had been offered

Thank you!Thank you!

18

12/6/2012

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 hat the ideal health benefit plan sho ld foc s on the 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 t ti ti l i k ti d l i ti d

19

protection 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 non-

vaccine covered plan sponsors with over half claiming that they would have included it if it had been offered

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% o ld recommend it to other emplo ers and 77% belie e that the cost would recommend it to other employers and 77% believe 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

20

There is a disconnect between perceptions and the reality of vaccine coverage: As about a quarter of plan sponsors overestimate that they are covered