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OPS Table Talk 2015 Issue 21 – Tiered Drug Formulary: Punishing those who need drugs the most

The biggest reason your bargaining team has rejected the employers proposed drug formulary is that it could severely hurt those who typically need the drugs most:  Retirees, the sick and those who depend on prescribed medicine to lead a healthy and normal life.

The employer says the new drug scheme would save millions of dollars. It implies that this money could be used to sweeten what it is offering in other areas of the negotiations.

It is offensive that the government would even think our members could endorse such a proposal. OPSEU’s vision is a better life for all its members. It is not to make gains for some on the backs of those who can least afford it.

Currently the employer pays 90 per cent of a drug’s cost.  But under the employer’s proposal, an outside panel would judge whether it thinks a drug is worth the money it costs. If the panel doesn’t like the drug your doctor prescribes, it will reimburse you far less money.  In some cases, the plan member would only be reimbursed 20 per cent of a drug’s cost. Under the employer’s scheme, plan members, and retirees in particular, could suddenly face drug bills of thousands of dollars.

The government says a plan member could appeal the panel’s decision, which is laughable. You and your doctor would have to show why your doctor’s preferred drug is appropriate. This could be a long and costly process, and you would have to pay for the time your doctor spends defending his or her choice. This is not really how you want to spend your time while you are sick.

The real solution is to include drugs in our national Medicare system.  If the federal government acted as a bulk purchaser for the entire country, it is estimated Canadians would save $7 billion a year in drug costs.

But until that happens, we want a drug plan for OPSEU members and retirees that is fair to all.

Download Table Talk 21

Related: OPS Bargaining 2014 Index Page