Vaccines are 'one of the most cost-effective interventions in preventing diseases'
The Ontario Pharmacists Association (OPA) is calling on employers to cover more vaccines for employees under their insurance plans.
Companies and their insurance plans should be praised for the fact that they are providing coverage for these vaccines, it says.
If they stop covering these vaccines, staff would have to pay out of pocket, which would in all likelihood lead to fewer people getting the vaccines.
“There's a lot of pharmacoeconomic data and study that goes on around each and every vaccine that comes to market that shows what the potential cost savings to the system is to the employer when we've talked about things like absenteeism and that loss of productivity at work,” says Jen Belcher, community pharmacist and vice president for strategic initiatives & member relations at the OPA, in talking with HRD Canada.
Preventative health care is something that employers should really invest in, she says. It’s important that they look at preventative health care as a “cornerstone” for insurance plans.
Many Canadians need prescription drugs, and most workers have access to employer-provided benefits that allow them to get their hands on these medicines, according to a previous Statistics Canada (StatCan) report.
Reducing complexities around vaccines in insurance plans
OPA is also calling on employers to cover all vaccines in their plans.
“I think everybody benefits from systems that reduce the complexity,” says Belcher.
“Right now around vaccines, there's a lot of complexity of what the government pays for, what employers are paying for, where you can go, how you access vaccines.
“Looking to a simple system in the future where if you're an immunizer and provide vaccines, you can provide all vaccines, that there's no exclusions from payment on private plans or surprises for employees down the line, and that people are able to confidently and easily take the steps needed to protect their health of both themselves and their family – that would be ideal.”
Vaccines, says Belcher, are “one of the most cost-effective interventions in preventing diseases” and “there's a lot of strong data justifying why employers would want to include vaccines on plans”.
Educating workers on importance of vaccines
One problem is that getting vaccinated for common diseases is not always the popular choice, says Belcher.
“There is a lot of apathy out there,” she says.
“Often, we see anywhere between 30% to 50% of the public choosing to get their flu shot each season. And the number of people being updated on their COVID vaccine series is dropping.”
This calls for employers to provide the necessary information to raise awareness among workers, she says.
Earlier this year, an arbitrator concluded that nine Ontario nurses who were fired because they didn’t get two COVID-19 vaccinations should be given their jobs back, finding their termination to be “unreasonable”.
Prescription for vaccines
With preventable diseases rising in Canada, vaccines are available. However, there are barriers to employer access, and employees could pay the price, according to OPA.
“The crux of the issue is, in many cases, the challenge of getting a prescription for those vaccines,” says Belcher.
She explains that many of these vaccines don't actually require a prescription in order for workers to get access to them.
“If I were paying out of my own pocket [and] not using my private benefits to get one of these vaccines, some of them I can buy from the pharmacy by having a conversation with the pharmacist. And the pharmacist will determine whether or not it's the right vaccine and provide information. And the pharmacist, in many cases, can actually even administer that vaccine in the pharmacy after the person purchases it.”
However, in order to use your private drug plan provided by their employer, they would need a prescription for the vaccine, says Belcher.
“So, I could go and buy it without a prescription. But in order for my plan to pay for it, it needs to be with a prescription written by someone who has what we call the scope of practice — the authority given to their profession to write that prescription for vaccines.”
OPA has been calling for the Ontario government to consider that expansion to the pharmacists’ scope of practice to make the process easier, she says.
“The prescriptive authority would be one way of fixing that and that would need change from the Ontario government to enable pharmacy pharmacists to do that.”
Another options, says Belcher, is for “some of the drug plans and the adjudicators, the pharmacy benefits managers – at the request of the employer – to include pharmacists in the list of professionals that could write a prescription for the vaccine”.
Specialty drug prescriptions are one factor pushing healthcare costs up for employers, according to a previous report.
