SMART drug plan
Approximately 94 per cent of Canadian plan members rank prescription drug coverage as an important component of their benefits plan, making it the top ranked benefit overall. Emerging trends in research and development have propelled us into a new era of prescription drugs.
At the core of our new SMART (sustainable, managed and reasonable treatment) drug plan is the goal of offering comprehensive coverage to plan members while balancing your plan sustainability.
What is the SMART drug plan?
This new drug plan is designed to meet your current and future drug coverage needs. It lets us target medication that can have a significant impact to drug plans.
Some of the key features include:
- The SMART assessment, which helps to determine if a drug or new indication on an existing drug should be excluded from coverage.
- Our SMART claims management practices by strengthening our Prior Authorization program.
The SMART assessment sets the criteria for SMART claims management. With the robust SMART assessment, we’re able to complete a thorough review that helps to reduce the amount of unknowns associated with a new drug or new indication of an existing drug.
We use the SMART claims management practices to determine if a new drug or new indication for an existing drug is eligible for coverage.
Making prior authorization even smarter
Under SMART claims management, we assess clinical effectiveness and compare new drugs to existing ones that are already proven to be effective for treating the same condition. We also look at cost effectiveness related to the disease and the stage of the disease, which adds another layer of protection for you.
For more information about your Great-West Life group benefits plan, contact your benefits administrator.