Insurer doubts over cancer treatments could push up price of private health schemes

Uncertainty over cancer treatments among private medical insurers could lead to significant financial consequences for employers providing private health schemes, according to consultants Watson Wyatt.

The licensing and use of drugs, including high profile cancer treatments such as Herceptin, are increasing, with the availability of such drugs already resulting in a debate about their potential cost to the NHS.

Similar financial and moral pressures will also need to be addressed by employers providing private medical benefit schemes for their employees, according to David Cross, head of healthcare and risk consulting at Watson Wyatt.

“In light of the growing public debate around the licensing and use of new high cost drugs to treat specific types of cancer, employers need to be very aware of the position that their provider is taking with regard to these treatments,” he said.

“Not only will the stance of their insurer result in an impact on the employee’s perception of the benefit programme, but employers need to understand fully the financial consequences of any decisions that they make, including the potential impact on other benefit and absence costs.

“Our guidance to all employers offering private medical benefits, and particularly those operating self-funded arrangements, is to ensure that such decisions are being taken using the best governance principles,” said Cross.

But he warned employers that any decision to restrict benefits could be subject to future challenge from claimants.

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