1. Evolving Data into Dollars Strategies and Accountability: Four essential elements to meet the reality of higher-cost drugs Oct 2012

2. Evolving Data into Dollars The Rationale for Benefits Attract/ retain employees Keep employees at work/return to work Good corporate citizens Balance of selfish and unselfish objectives

3. Evolving Data into Dollars Four Essential Elements Innovation in plan design Foster employee consumerism Challenge/lobby government Measure and respond

4. Evolving Data into Dollars Innovation in design Why were drug benefit plans designed with a flat fee co-pay?

5. Evolving Data into Dollars Innovation in design Plan design needs to evolve to keep pace with evolving realities (escalating costs) Sharing of high priced drugs by insurers step in the right direction Need to examine ways to combine: –Flex benefits/defined contribution/healthcare spending accounts Pluck ideas from the US –High-deductible, account-based consumer-directed health plans (CDHPs) Break the old Models –Carve out insurance for select disease categories and continue ASO for balance Build exceptions into the process

6. Evolving Data into Dollars Employee Consumerism Source: Harness the potential of Generation Y, http://www.sunlife.ca/static/canada/Sponsor/Bright%20papers/GenY%20BrightPaper%20E.pdf

7. Evolving Data into Dollars Employee Consumerism Source: Harness the potential of Generation Y, http://www.sunlife.ca/static/canada/Sponsor/Bright%20papers/GenY%20BrightPaper%20E.pdf

8. Evolving Data into Dollars Employee Consumerism Employees need to make informed decisions about their benefits Need to examine ways to combine: –Flex benefits/defined contribution/healthcare spending accounts –Elements of consumer-directed health plans (CDHPs) Allow accumulation and role over Optional/non-optional insured components for high cost disease areas Seek tax advantaged treatment of premiums for high cost areas (like LTD)

9. Evolving Data into Dollars Challenge/lobby government What percentage of drugs for renal cell cancer are funded by the private sector? Ten years ago?

10. Evolving Data into Dollars Challenge/lobby government Significant percentage of product pipeline in cancer are oral meds (1/3) and other biologics are often oral formats Private sector share of drug coverage increasing and will continue to do so Government NOT playing well with others What can be done? –Stop providing benefits –Dump on your employees –Live with it –Work to change the environment

11. Evolving Data into Dollars Challenge/lobby government Work to change the environment –Define government roles/accountability –Tax supportive policies –Push for trade offs –Quantify expenditures

12. Evolving Data into Dollars Measurement Considering all drugs paid for in the private sector in 2011, what are the top 3 diseases being addressed? “While 82% of respondents agree that their company’s benefits plans provide good value … only 29% say they calculate the ROI of their plans Leigh Doyle | August 01, 2012 http://www.benefitscanada.com/benefits/health- benefits/justifying-the-investment-30572 Considering all drugs paid for in the public sector in 2011, what are the top 3 diseases being addressed? What is the potential cost impact to the private sector of prostate cancer in 2020?

13. Evolving Data into Dollars Measurement Tools can be built to provide strategic insights in healthcare expenditures Challenge existing providers Create industry/private sector working groups to design/fund/build Work with the Pharmaceutical industry Utilize technology as an enabler “While 82% of respondents agree that their company’s benefits plans provide good value … only 29% say they calculate the ROI of their plans Leigh Doyle | August 01, 2012 http://www.benefitscanada.com/benefits/health- benefits/justifying-the-investment-30572

14. Evolving Data into Dollars Who owns this? Gov’t Employees Employers Health Care Community Innovation in plan design Foster employee consumerism Challenge/lobby government Measure and respond WHO NEEDS TO LEAD IT?