Rising Cancer Claims Will Impact Employers

cost efficient benefit plan

Since the arrival of COVID-19, employers have been dealing with a range of employee health issues beyond the pandemic itself. Mental health quickly became a concern as employees dealt with the disease as well as financial concerns, working from home and having kids doing school online. However, some employers are now talking about a growing shadow pandemic of serious and chronic illnesses, including cancer.

Cancer in Canada

More than 200,000 Canadians are diagnosed with cancer each year. In Canada, the most commonly diagnosed types of cancer are lung, breast, colorectal, prostate and skin cancer. An estimated 2 in 5 Canadians will be diagnosed with cancer in their lifetime and about 1 in 4, or 25% of Canadians will die of cancer. In fact, cancer is the leading cause of death for Canadians, and when hospitals were overwhelmed with pandemic patients, there were delays in cancer testing, diagnosis and treatment which will have long term consequences perhaps for years.

Meanwhile, the Canadian population is aging, and this is expected to cause a rise in new cancer diagnoses by 40% by 2030. The good news is that Canada is a world leader in cancer research and has some of the highest cancer survival rates in the developed world.

Cancer Claims

What does this mean for employers? Delays in cancer testing, diagnoses and treatments is a major concern for employers. The Canadian Cancer Society states that a treatment delay of four weeks increases the risk of death by 10%. Ontario has a backlog of more than 16 million surgeries, diagnostic exams, screenings, procedures, including 700,000 missed or delayed MRIs and CT scans. As many as 43% of plan sponsors worry that claims for cancer and other serious diseases will continue to rise because of delays in being addressed during the pandemic.

New Medications

Rising cancer cases in Canada are being met with Canada’s development of its second cancer drug, Rozlytrek, which targets tumours based on genetic properties. This drug is regarded as a breakthrough in treatment for rare cancers. Canada’s first cancer medication, Vitrakvi was approved in 2019, and Rozlytrek was approved in 2020. The costs of these drugs is extremely high (approximately $200,000 per year) and beyond the scope of company benefit plans.

Challenges for Benefits Managers

While the COVID-19 pandemic may seem to be on the decline, the “shadow pandemic” of cancer is on the rise. This will pose new challenges for benefits managers to deal with employees with serious or chronic disease. In extreme cancer cases, the cost of Canada’s new medications are currently not likely to be covered by company plans. But there are other tools that benefits plans can incorporate such as virtual care, and encouraging employees to access the employee assistance programs (EAP). Educating employees about their benefits, about wellness and prevention of illness and disease through company support of positive lifestyle changes are the best ways for plan managers to navigate the dynamics of an aging workforce and sustainable benefits plans.

Virtual Care

Plan sponsors have opportunities to support employees with innovative benefits. For example, virtual care exploded over the past two years and continues to grow as two thirds of plan members say they will continue to use virtual care going forward. Employees value the convenience of being able to access care or consultations from physicians and therapists through videos, texts, or by phone. Another benefit is virtual pharmacy services which can assist patients with ordering and managing their prescriptions online, as well as discussing side effects.

At Health Risk Services, we specialize in helping benefits plan managers respond to the changing needs of their employees’ health concerns while finding solutions that are financially sustainable.

At Health Risk Services we will Empathize, Educate, and Empower you and your team in 2022!

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