Specialty Drug Care: Case management services in Quebec

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1 Specialty Drug Care: Case management services in Quebec QUEBEC SUPPORTING HEALTHIER OUTCOMES

2 Your health benefit plan is designed to provide you and your family with financial protection for a variety of medical expenses, including prescription drugs. Specialty Drug Care is a program that helps manage healthcare costs while providing the additional support of a nurse case manager for individuals taking medications to treat complex chronic or life threatening conditions. It s about caring, not just healthcare. Bayshore HealthCare

3 Introducing Specialty Drug Care We understand that it can be difficult to navigate the health care system on your own and to access resources or information when you or your eligible dependants have been diagnosed with a complex chronic or life threatening condition. With a focus on improving the experience for plan members taking specialty drugs, Manulife has partnered with Bayshore HealthCare Ltd., the largest private community healthcare provider in Canada, to deliver Specialty Drug Care. You may not recognize Bayshore s name but you can take comfort in the fact that they have been operating in Canada for over 40 years and employ over 11,000 healthcare professionals nationwide. Bayshore has a proven track record of providing quality community healthcare and specialty pharmacy services to Canadians. Specialty Drug Care is designed to complement your health care by filling gaps and ensuring continuity of care.

4 What are specialty drugs? Specialty drugs are high cost * medications used to treat complex chronic and life threatening conditions. They may require special storage, handling and administration, and involve a significant degree of patient education, monitoring and management. Many of these drugs also require injection or infusion. Case managementservices in Quebec will focus on the following health conditions: Inflammatory conditions such as Rheumatoid arthritis and Crohn s disease Multiple sclerosis (MS) Cancer (oral meds only) Rare or genetic diseases such as Parkinson s disease Hepatitis C *usually more than $600 per month

5 Specialty drugs can be life altering - delivering relief from pain and discomfort, or providing new treatment where no other existed before.

6 Case management is at the heart of our program Specialty Drug Care delivers case management services that optimize specialty drug use and provide additional support when you, or your eligible family member, need it most. Your designated nurse case manager will be the consistent person to help you to better understand your health condition, the medication you re taking, and how to manage any side-effects. In cases where there are opportunities to do more to help you manage your condition, the nurse case manager will support you with health coaching or referrals to services such as physiotherapy or occupational therapy. They may also direct you to receive further testing to ensure that your medication is working, and that your condition is being managed as expected. In summary, specialty case management services may include: Disease and medication education Side-effect management support Working with you to ensure you re taking the drugs as prescribed and at the right frequency

7 Coordinating efficacy testing and/or assessment to ensure the drug therapy is working Encouraging the use of lower cost treatments, where appropriate Facilitating discussions with physicians Prescription renewal reminders Initiating referrals to community-based resources to support treatment (e.g., occupational therapy or physiotherapy) Delivering health coaching to address exercise, diet, smoking-cessation or stress Locating alternative sources of funding such as provincial programs to help manage any medication expenses that are not covered by your plan Explaining and helping you get enrolled in patient assistance programs Case management services are conveniently delivered by phone. Your designated nurse case manager will help support you through the program and is responsible for ensuring your health care needs are met.

8 How the program works is quite simple! When you have a new prescription for drugs included in the Specialty Drug Care program, a nurse case manager will contact you by phone to introduce you to program and to help you manage your condition All the medications included in Specialty Drug Care require prior authorization, a standard element of your drug plan. Prior authorization drugs will require additional medical information from your doctor prior to being eligible. Discover how Specialty Drug Care can help you manage your health! Manulife, the Block Design, the Four Cube Design, and Strong Reliable Trustworthy Forwardthinking are trademarks of The Manufacturers Life Insurance Company and are used by it, and by its affiliates under licence. GB3857E 04/15