Alternate Coverage Options for Medication

On the topic of finding the right solution for your organization, another creative option that we’re seeing more frequently in the benefits space is the emergence of Patient Assistance Programs for prescription drugs.

Two different providers offer this type of program in Canada, RxHelpOne and innoviCares, sponsored by pharmaceutical companies. In the program, an individual gets a card which helps subsidize the cost of their brand name prescription medication, such as Vyvanse, Wegovy, Cipralex and Concerta. These programs are particularly useful for people who don’t have any type of coverage, those who have maxed out their coverage, or for individuals who want to combine it with government sponsored programs.

If a person does not have 100% coverage for prescriptions, this can reduce out of pocket expenses. Anyone can sign up – an individual gets assigned a “case manager” who will help them explore what is available and what type of subsidization they would receive in the program. One provider recently announced that they now cover a portion of the cost for Wegovy (an alternative to Ozempic), which is quite timely given the popular rise of GLP-1 weight loss drugs.

If you’re interested in letting your employees know about these types of programs, Shannon can help. We can look at the providers together and tailor custom communication for your organization to get the word out. Contact me and let’s see what would work for your people!