November 24, 2017

Employers are asking us to cut methadone coverage in their benefit plans. Here's why we're no longer doing so.

November 24, 2017

In the last 3 months, we've received an unprecedented number of requests to remove coverage for methadone / methadose coverage from their drug benefit plans.While it's doable from a systems perspective, we can't help but ask: what is the cost of a human life?If methadone hits an employer sponsored benefit plan, the costs can be $20 per day, for every day of the year. This is because patients have to show up to the pharmacy daily, for a single-day's supply, and take the med while the pharmacist watches.If you have one or more employees with this prescription, the costs can range from $4,000 to $10,000 per year and up...depending on the number of other medicines the patients are taking, sometimes in the same category of pain management.While it's a new cost hitting employers, we note that some carriers will and will not eliminate this coverage.Ethical Considerations

  1. Discrimination based on disability. Can you imagine if your employer wanted to cut migraine medicine? What about birth control? Or cancer meds? Canadian common law typically has a broad definition of 'disability' and addiction is certainly part of that scope. Therefore, why would HR eliminate coverage for one disability but continue to fund coverage for a different one?
  2. What will that employee turn to? Think for a second. An employee has an addiction. You remove access to addiction management (methadone). The employee, making minimum wage, can no longer afford $20 per day. What do they turn to? What other, more dangerous drugs do they rely upon, which are less expensive? And what happens to that employee's ability to go to work and earn a livelihood if they are using other drugs?
  3. How did we get here? As I write this, it's a matter of public record that criminal charges have been launched against the makers of pharmaceutical grade pain medicine, and the vicious and complicit marketing campaigns targeting language that the medicine is not addictive. Why are we punishing our team members for following prescribing instructions of their trusted physicians?

If you are an HR Manager or group benefit plan influencer, I urge you - please, think about the ethical considerations before you eliminate coverage for methadose or other substance abuse therapies.Thank you.


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