Practical guidance for Ontario business owners & plan sponsors
Proactive drug management helps control renewals while maintaining competitive coverage.
1
Encourage Mandatory Generic Use
- Generic drugs are Health Canada–approved and therapeutically equivalent to brand-name drugs.
- They typically cost 30–80% less than brand equivalents.
- Most benefit plans reimburse at the generic price when available.
2
Promote Conversations About Lower-Cost Alternatives
- Prescribers may not be aware of plan pricing differences.
- Encourage employees to ask about lower-cost medications that work the same.
- Reduces unnecessary brand utilization and long-term cost escalation.
3
Manage Dispensing Fees Through Smart Pharmacy Use
- Dispensing fees vary widely across Ontario pharmacies.
- Multiple monthly refills increase total plan costs.
- Encourage the use of one pharmacy and 90-day supplies for maintenance medications.
4
Leverage Brand-Name Drug Savings Programs
- Manufacturer-sponsored programs can significantly reduce claims for required brand-name drugs.
- Common Ontario programs include InnoviCares and RxHelp.
- These programs may cover the cost difference between brand and generic drugs
5
Specialty & High-Cost Drug Oversight
- A small number of high-cost drugs can disproportionately impact renewals.
- Best practices include prior authorization and specialty pharmacy use.
- Ongoing case management ensures appropriate utilization.
6
Coordinate With Ontario Government Programs
- Employees may qualify for OHIP+ or the Trillium Drug Program.
- These programs can supplement workplace benefits.
- Proper coordination can reduce employer-paid claims.
7
Education Before Renewal Matters
- Simple employee education can shift prescription behaviour.
- Annual reminders before renewal are most effective.
- Small changes can have a meaningful impact on renewal outcomes.
How Norbram Helps
Norbram works with business owners to proactively manage prescription drug costs through plan design
strategy, claims analysis, and ongoing education. By identifying cost drivers early and implementing
practical controls, we help reduce renewal volatility while protecting the employee experience.
