Will employers include the abortion pill in drug plans?

Sara Tatelman | October 17, 2016 | Benefits Canada

Health Canada approved the abortion pill Mifegymiso in July 2015. Late last month, however, all provinces but Quebec announced they wouldn’t include the medication in their formularies because manufacturer Celopharma refused to fund a cost-effectiveness study. On Oct. 7, Celopharma reapplied for the Common Drug Review, which is open for patient input until Nov. 25.

Many employer-sponsored plans, on the other hand, don’t wait for the common drug review before adding a new medication, Joan Weir, director of health and dental policy at the Canadian Life and Health Insurance Association in Toronto, told Benefits Canada in an email.

“Those employers with open formulary plans would likely already have this drug added,” she said. “Others will likely add over the next six to nine months.”

Insurers generally don’t add a new drug right away when a managed formulary is in place, Weir added.

For Pacific Blue Cross’ employer-sponsored health benefits plans, Mifegymiso is only included upon the employer’s request, director of pharmacy services Joanne Jung told Benefits Canada in an email.

Manulife, on the other hand, covers the drug if it’s prescribed by a physician who has completed Celopharma’s educational program, according to Lisa Callaghan, assistance vice-president of product for group benefits.

While it’s important to include Mifegymiso in drug plans, employers can do more to support employees who have an abortion without even knowing that it’s happening, says Sandeep Prasad, executive director of Action Canada for Sexual Health and Rights in Ottawa.

“One of the biggest things an employer can do is offer paid sick leave for their employees,” he says, noting Health Canada has approved Mifegymiso for up to seven weeks of gestation. If an employee must choose between their health and their income, they may delay making an appointment with their physician, passing the seven-week deadline for the medication, and requiring a surgical abortion, which is more expensive and more time-consuming.

“This would usually require a single day off to access Mifegymiso,” Prasad says, also noting a doctor’s note shouldn’t be necessary or, if it is required, employers should accept generic cialis onlinemedications lowest prices reasons.

Posted on 2016-11-10
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