Price Makes Biosimilar Switching Attractive

The battle over shifting patients from biologics to biosimilars is the same as that when generic drugs were first introduced 30 years ago, says Ned Pojskic, pharmacy strategy leader at Green Shield Canada, at the CPBI Atlantic Regional Conference on ‘Biologic and Biosimilar Drug Strategies: The Point/Counterpoint in Canada.’ Joe Farago, executive director, policy, private markets, and investment, at Innovation Medicines Canada, opened the discussion explaining that biologics are made with living cells using complex manufacturing processes. Biosimilars are a biologic medical product that is almost an identical copy of an original which offers the same results. This is unlike generics which are actually the same as small molecule drugs. However, like generics, biosimilars can come at a lower price which is one of their primary attractions. Kevin O’Connor, director, federal and private healthcare, at Janssen Pharmaceuticals, said biosimilars are an approved safe effective medical treatment. However, he contended the jury is still out on whether switching from biologics to biosimilars is safe. While there is lots of research which says this causes no problems, research and physician groups are split on switching and many patient groups are against it. One study deemed this practice safe as only four per cent of those studied did worse after switching, he said. However, it was only deemed ineffective if a patient was no more than 14 per cent worse. And while Europe is held out as an example of biosimilar switching success, the number of different models and approaches varies enough that it is difficult to make an overall statement. This data is not “definitive,” he said, only a “marker.” He believes the best approach is competition where there is no mandatory switching or use of biosimilars. Instead, the choice is left to the patient and doctor. Pojskic said most agree with the approach where biosimilars are prescribed first to new patients. The question is whether they can be switched and he said there is enough evidence on the safety of switching. However, in Canada, some patient groups refuse to participate in the discussion about biosimilar switching and then, when the decision is made, claim they were never consulted. This, too, is confusing as in the U.S. some like the Crohn’s and Colitis group in the U.S. is okay with switching and even with payers initiating this. Canada needs to look at this globally, he said, as increasingly the climate is that switching is the safe thing to do, he said.

Workplaces Not Allowing Cannabis

Nearly one year after cannabis legalization in Canada, a study from Ipsos, commissioned by ADP Canada, reveals most Canadian workplaces don’t allow recreational cannabis before, during, and after work. Most working Canadians (86 per cent) say their employer does not permit recreational cannabis use and only a fraction (eight per cent) say cannabis use is allowed during the workday. These findings are in line with a similar study conducted by ADP in 2018 where six per cent of Canadians thought they would be allowed to use cannabis during work hours or before coming to work. Most Canadians believe recreational cannabis has had no impact at work in terms of health and safety incidents (75 per cent), productivity (74 per cent), absenteeism (71 per cent), or quality of work (70 per cent). This is in stark contrast to opinions held prior to legalization in 2018, when nearly half of working Canadians expected productivity (46 per cent) and quality of work (43 per cent) to decline and health and safety incidents (55 per cent) and absenteeism (40 per cent) to increase. Within the small number of working Canadians (eight per cent) who say their employer allows the use of recreational cannabis, 63 per cent are consuming it before work, 47 per cent are consuming during work hours, and 72 per cent are consuming after work (72 per cent). However, when looking at Canada’s working population at large, the survey finds that only a fraction of Canadians consume recreational cannabis before work (five per cent), during work hours (four per cent), and after work with colleagues (six per cent).

Definition Of ‘Good Pension’ Varies

Sustainability does not necessarily mean adequacy, says Blair Richards, CEO at the Halifax Port ILA/HEA. Speaking on ‘Sustainability ≠ Adequacy’ at the CPBI Atlantic Regional Conference, he said for too long conversations about pension plan sustainability have focused on the front end have been sponsor biased. The definition of a “good pension” can vary depending on who is deciding. Company senior executives think about the pension plan in the business case, not for the beneficiaries. Regulators and politicians want to avoid the “black eye” they get when plan blows up. So they are focused on getting members what they were promised, overlooking any sense of whether it was enough after 30 years of retirement. This leaves retirees to the ravages of inflation. He said more focus needs to be put on the back-end, after members retire. This may require more pension options, immigration to solve a growing dependency ratio issue, a focus on long-term solutions, and auto “everything’ from enrolment to the emerging trend of portability where pensions follow workers as they move from job to job.

Aon Aligns With Cyber Security Awareness Campaign

Aon plc is launching a campaign aligned with the Canadian Cyber Security Awareness month to foster education on emerging cyber threats facing organizations from all industry segments and sizes. The campaign aims at introducing new resources to Canadian organizations, such as its dynamic cyber risk management portal, CyQu, the Cyber Deal Desk, and cyber-focused teams of experts whose mandate is to educate on emerging topics. “We receive reports of breaches experienced by our Canadian clients on a weekly basis,” says Catherine Bertheau, business development lead for Aon in Eastern Canada. “The pace is accelerating, the loss quantum is unprecedented, and, sadly, we still see too many clients playing catch up, thinking cyber-risk is a distant concept sitting low on the priorities list. With an expanding dependence on digital assets, cyber-crime continues to grow and shows no signs of slowing down. Our industry, amongst other actors, needs to step up to improve our collective resilience to foreign threat actors.”

Time To Check On Dental Costs

Joan Weir, director, health and disability policy, at the Canadian Life and Health Insurance Association (CLHIA), it is easy to see a 2.1 or 2.7 per cent increase in dental claims costs and think nothing of it. She told the CPBI Atlantic Regional Conference session on ‘The Rising Costs Of Dental Benefits: It’s Time for a Check-up,’ rising costs here are being overlooked. In fact, dental utilization is up 5.16 per cent and the dental cost is 3.13 per cent higher. This is due in part to the changing nature of dental practices. The number of dental professional has also risen 35 per cent in the past decade. As well, the cost of purchasing a practice by a retiring dentist is huge. Other drivers of cost include new technologies like 3-D printers which can be used to create new teeth. The development of new codes/code changes by dental associations across the country are also resulting in higher recommended dental fees. There are, however, some cost containment measures that plan sponsors can put in place. Value based payments are big in the U.S., but are coming to Canada. Here, scorecards are created for a dentist and they are paid according to the effectiveness of the treatment. Another approach splits the diagnosis from the treatment. A patient gets a diagnoses from one dentist and then shops around for the best price. She said Canadians are also heading to places like Costa Rica for dental procedures because the cost is much cheaper.

Change Providing Opportunities

Change is good and the ongoing changes in the group insurance brokerage industry provide opportunities to brokers, says Dave Patriarche, president of Mainstay Insurance Brokerage Inc. and founder of Canadian Group Insurance Brokers (CGIB). During his presentation, ‘The Future Is Bright,’ at the CGIB October breakfast seminar, he said brokers are dealing with change in the areas of whether to give advice to clients, amalgamation, regulation, liability, disclosure, and larger companies selling direct. However, while these changes may have some negative impact, they also offer key opportunities for smaller brokers to excel. For example, giving advice can be a differentiator. “If you become a specialty advisor in a specialty market, you can do very well,” he said. “Be the best advisor to trucking companies.” Amalgamation creates large companies that focus on efficiencies and keeping down costs. Smaller brokers can compete by offering flexibility, relationships, and high service levels. As well, merged companies often don’t go outside of their markets, so this gives smaller brokers greater market access. Changes in regulation creates a reason to use an advisor, so this is another value-add brokers can offer. “The more complicated the [regulation] is, the more reason they need advice.” Providing risk analysis or assessments is another way brokers can help clients when it comes to liability. “Show them you are working for them and not for yourself or the insurer,” said Patriarche. “Design plans that protect the clients, not the insurers, and make yourself invaluable.”

Two Organizations Join CAAT

CAAT has added two organizations to its growing roster of participating employers. As part of their new collective agreement, workers from the University of Saskatchewan and Federated Colleges Non-Academic Pension Plan, represented by CUPE 1975, joined DBplus on a go-forward basis effective September 1. As well, employees from Community Living Toronto joined the CAAT plan effective October 1. Pending regulatory approval, Community Living Toronto will merge its prior defined benefit pension plan liabilities and assets into CAAT. Members of the Community Living Toronto pension plans consented to the merger, voting an overwhelming 93 per cent in favour, with unionized members represented by their local CUPE 2191. These two new employers add over 2,000 new members to DBplus – 700 from Community Living Toronto and 1,300 from the University of Saskatchewan. Members will pay into the DBplus plan at fixed contribution rates, with their respective employers matching dollar for dollar.

Large Managers Moving Portfolios In-house

Large global asset owners increasingly manage greater portions of their investment portfolios in-house as they look for ways to reduce fees, enhance control, and drive overall investment performance, says a Northern Trust white paper. ‘The Changing Tide: The Evolution of the Asset Owner Investment Model’ says motivated by rising costs, new technology, global regulatory change, and a drive toward fund consolidation, almost one out of five (19 per cent) institutional investors have increased the proportion of assets that are managed in-house in recent years. “As asset owners evolve their investment models to include more in-house management, they are re-evaluating the process from start to finish,” says Dan Houlihan, head of asset servicing, Americas at Northern Trust. “They see opportunities to increase efficiencies, control costs, and achieve regulatory compliance by outsourcing non-core functions across their back, middle, and front office. These include a variety of activities from collateral management to foreign exchange; investment operations to compliance monitoring; and client reporting to trade execution.” It says before insourcing portfolio management asset owners should consider the full spectrum of costs and risks as well as the opportunities – including implementation costs, investment expertise, technology requirements, and regulatory compliance, as well as the need to deliver operational efficiency.

Network Shares Lessons On Climate Change Reporting

An Investor Leadership Network (ILN) report shows how global investors can strengthen their climate change reporting. It shares the lessons learned by ILN members while implementing the Task Force on Climate-related Financial Disclosures (TCFD) recommendations. ‘TCFD Implementation, Practical Insights and Perspectives from Behind the Scenes for Institutional Investors’ is intended to assist asset owners and fund managers in making better choices to define their climate change strategies and disclosures. The report provides real world examples that show how TCFD recommendations are being put into practice by different institutional investors around the world. It acknowledges that investors globally are at different stages in their TCFD implementation journeys and that providing consistent, comparable, and reliable climate-related information takes different shapes and forms as the recommendations are adopted.

Ontario Launches Venture Incubator

The Ontario Teachers’ Pension Plan is launching a venture incubator with a twist – it’s focused exclusively on building novel ideas with the companies in its own portfolio. Koru is designed to create, test ,and build scalable new digital businesses. It is already generating ideas in sectors including healthcare, utilities, and transportation. Its first venture, Elovee, has the ability to bring the comfort of a familiar face and voice to dementia sufferers in the middle of the night, or at other times when those closest to them cannot be physically present. Wholly-owned by Ontario Teachers’, Koru is a partnership with BCG Digital Ventures ‒ the global corporate venture, investment, and incubation arm of Boston Consulting Group.

Bercsenyi Joins ENMAX

John Bercsenyi (FSA, FCIA) is a pension and benefits specialist at ENMAX on an 18-month contract. He has held consulting positions with Mercer and Willis Towers Watson as well as a reinsurance actuarial analyst position with Crown Life Insurance since entering the industry in 1997.

Benefits Overview Provided

Designed by CPBI Ontario, the ‘HRPA Canadian Benefits Certificate Program’ will provide a comprehensive overview of benefit programs in Canada. Sessions will examine the basics and developing better strategies, managing programs more effectively, and keeping escalating costs under control. Each day builds on the knowledge and skills of the previous level. It takes place November 5 to 7 in Toronto, ON. For information, visit Benefits Certificate