Mercer is advising companies not to rush into a review of cancer cover given recent market changes. The precise implications of the recent announcements by the NHS of the formation of a £200m fund for cancer drugs and the review of National Institute for Health and Clinical Excellence’s (NICE) role in approving cancer drugs are as yet unknown. Given that, the consultancy has warned that companies looking to renegotiate terms of cancer cover with insurers may benefit from delaying the process until more clarity is provided.
According to Mercer, corporate healthcare coverage that was appropriate five years ago may, given these changes, now provide either an unwanted financial liability or a shortfall in cancer coverage. This risks an uncapped financial exposure, inconsistency or accusations of discrimination.
The situation is aggravated, believes the consultancy, by health insurers using different criteria to adjudicate what their plans will and won’t pay for, as well as setting the maximum cover based upon a range of factors, including the stage of the disease; length of treatment; episodes of treatment; and in some cases, cost.
Naomi Saragoussi for Mercer says, “Employers find it difficult to understand what their policies will fund and makes benchmarking the provision complex, resulting in significant differences in what employers offer. Until the government has clarified what cancer drugs will be available on the NHS, companies should be wary of committing to polices to pay for treatments that may eventually be offered free through the state.”
Mercer has recently commissioned a full review of the cancer benefits available within the insurance market to provide some clarity for employers on the situation.