Insurer Case Management and Patient Support Program Services in Canada
Benefits Canada
Insurer case management (ICM) programs and
patient support programs (PSPs) both have a goal to provide services that will
help maximize health outcomes for Canadian patients who are prescribed
high-cost specialty medications. Manufacturer-funded PSPs provide reimbursement
navigation, education, and medication administration and logistical support to
patients who are prescribed a specialty therapy. Insurer-funded programs aim to
help patients adhere to their treatment plans, and to collect important
information to assist insurers in making coverage decisions. There are benefits
and differences between these two models, which are important for insurers and
plan sponsors to understand.