TABLE 1.
Use of cost-control mechanisms by private benefits plans in Canada*
| % of Employees | 1998 | 2010 |
|---|---|---|
| Formulary Management Mechanisms | ||
| Generic substitutions mandatory | N/A | 67% |
| Multi-tiered | N/A | 19% |
| Cost-Shifting Mechanisms | ||
| Patient maximum (Annual and/or Lifetime) | N/A§ | 16% |
| Annual maximum | 3% | 12% |
| Lifetime maximum | <3% | 6% |
| Deductible | 48% | 12% |
| Co-payment (Fixed and/or Percentage) | 71% | 79% |
| Fixed amount | 12% | 13% |
| Percentage amount | 58% | 61% |
| Combination (fixed and percentage) | 2% | 4% |
| Dispensing fee | 3% | 27% |
*
Numbers have been rounded.
§
Patient maximums (annual and/or lifetime) were not discussed in the report on 1998 data; however, looking at the use of annual and lifetime maximums separately, we are confident that less than 16% of employees had some sort of limit on their plan.
Sources: Applied Management Consultants in association with Fraser Group and Tristat Resources 2000, and the authors' calculations using data provided by Applied Management, from their private plan data set, 2010.