2025年面对面药物计划管理论坛：缩小疫苗与健康福利计划之间的差距-动脉网

2025 Face to Face Drug Plan Management Forum: Closing the gap between vaccines and health benefits plans

benefitscanada 等信源发布 2026-01-28 20:56

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Suzanne Lepage

苏珊娜·勒帕热

“Immunization is one of the best investments money can buy, according to the World Health Organization,” said Johnny Ma, president at Mapol Inc., during a session supported by GSK, Merck and Pfizer Canada during

“世界卫生组织认为，免疫接种是金钱能买到的最佳投资之一，”Mapol公司总裁马约翰在由GSK、默克和辉瑞加拿大支持的会议期间表示。

Benefits Canada

加拿大福利

’s 2025 Face to Face Drug Plan Management Forum.

2025年面对面药物计划管理论坛。

Canadian data shows vaccines can save $2.5 billion a year in unnecessary health costs and lost productivity, with a 341 per cent return on every dollar spent, he said. But despite these benefits, significant gaps remain. “Private plans nationally paid about $326 million in vaccine claims; however, 1.5 million claims were rejected.”.

他说，加拿大数据显示，疫苗每年可节省 25 亿美元的不必要医疗费用和生产力损失，每花费 1 美元即可获得 341% 的回报。但尽管有这些好处，仍然存在显著的差距。“全国私人保险计划支付了约 3.26 亿美元的疫苗索赔；然而，有 150 万项索赔被拒绝。”

Ma also highlighted that only 71 per cent of Canadians with private insurance have vaccine coverage, leaving about seven million without. The gap is even larger for small businesses, where 46 per cent don’t include vaccines in their plans. Insurer’s classifications of vaccines as lifestyle or optional is a legacy from when vaccines were primarily for children and were publicly funded, he noted “The landscape has changed but their policies have not modernized.”.

马还强调，只有71%的加拿大人拥有私人保险的疫苗覆盖，约有七百万人没有。小企业的差距更大，46%的企业未将疫苗纳入其计划。他指出，保险公司将疫苗归类为生活方式或可选项目，这是从疫苗主要针对儿童且由公共资金资助时遗留下来的问题。“环境已经改变，但他们的政策并未现代化。”

Read:

读取：

2024 Face to Face Drug Plan Management Forum: Panel: A look at the evolution of drug coverage

2024年面对面药物计划管理论坛：专题讨论会：药物覆盖的演变一瞥

Ma also pointed out administrative barriers, such as requiring a doctor’s prescription for Schedule 2 vaccines, which are available behind the counter at pharmacies and don’t legally require a prescription. “Why should plan members be asked to get a prescription when six million individuals don’t have a family doctor in Canada today?”.

马还指出了行政障碍，例如要求医生处方才能获得第二类疫苗，而这些疫苗在药店柜台后就可以买到，法律上并不需要处方。 “当加拿大今天有六百万人没有家庭医生时，为什么还要求计划成员去获取处方呢？”

Sharing highlights of Mapol’s

分享Mapol的亮点

2025 vaccine coverage report card

2025年疫苗覆盖率报告卡

, which graded insurers on how they include vaccines in their benefits plans, he said seven insurers achieved an A grade for group benefits, with Sun Life recognized for consistency across group and personal health plans. Others, such as the Co-operators Group Ltd., the Empire Life Insurance Co., Desjardins Insurance, Group Medical Services, RBC Insurance Services Inc.

，该评分根据保险公司如何将疫苗纳入其福利计划进行分级，他说有七家保险公司在团体福利方面获得了A级，其中永明人寿因在团体和个人健康计划中的一致性而受到认可。其他公司，如合作社集团有限公司、帝国人寿保险公司、德贾尔丹保险、团体医疗服务、加拿大皇家银行保险服务公司。

and Saskatchewan Blue Cross, were also identified for leadership..

并且萨斯喀彻温蓝十字会被认定为领导角色。

However, he noted eight insurers still treat vaccines as optional and six received an E grade, meaning coverage is only provided if plan sponsors request it.

然而，他指出，仍有八家保险公司将疫苗视为可选项，六家保险公司被评为E级，这意味着只有在计划发起人要求时才提供覆盖。

Read:

读取：

2024 Vancouver Benefits Summit: How plan sponsors can boost vaccine uptake among employees

2024年温哥华福利峰会：计划发起人如何提高员工的疫苗接种率

Ma recommended that “insurers make vaccines a standard inclusion now — not next year, not the next product review, not when it’s convenient, now. The economics and public health evidence support it and plan sponsors’ employees need it.”

马建议“保险公司现在就将疫苗纳入标准条款——不是明年，不是下一次产品审查时，也不是方便的时候，而是现在。经济和公共卫生证据都支持这一点，而且计划赞助商的员工也需要它。”

He urged plan sponsors to proactively request vaccine coverage and communicate it to employees and for advisors to advocate for standard vaccine inclusion and to educate plan sponsor clients on its importance.

他敦促计划发起人主动要求疫苗覆盖，并将其传达给员工，还敦促顾问倡导将疫苗纳入标准，并向计划发起人客户宣传其重要性。

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Keywords

关键词

2025 Face to Face Drug Plan Management Forum,

2025年面对面药物计划管理论坛，