WELLESLEY, Mass., July 16, 2018 /PRNewswire/ -- In Sun Life
Financial's 2018 High-Cost Claims Report, cancer remains the
costliest medical condition, with $798.7
million in reimbursements to self-funded employers from 2014
to 2017. The report, based on analysis of Sun Life's database of
over 62,000 medical stop-loss claimants from 2014-2017, shows that
high-cost conditions totaled $6.9
billion in paid charges over the four-year period. The
number of patients with million-dollar+ claims rose 87 percent,
from 104 in 2014 to 194 in 2017, with most charges ranging from
$1 million to $1.5 million, and totaling over $935 million in paid charges.
"We're seeing continued significant growth in the number of
million-dollar-plus claims as the result of new life-saving
treatment options coming to market, as well as existing treatments
getting approved for expanded use," said Dan Fishbein, M.D., president of Sun Life
Financial U.S. "This means better care and outcomes for patients,
and is also an important consideration for employers who self-fund
their medical plans. We partner with our clients to protect them
from the financial risks of these high-dollar claims, but also to
work with them to identify opportunities for cost savings that may
improve patient care as well."
Other analysis from the report showed that:
- Rare conditions hit highest dollars – The two highest claims
for a patient in a single policy year were for metabolic/immunity
disorder (hereditary angioedema, a severe, recurrent swelling of
various parts of the body) in 2016, with a total of $6.7 million in treatment costs; and
hemophilia/blood disorder with a total treatment cost of
$5 million in 2017.
- Million-dollar cases leave big footprint – Patients with claims
over $1 million represented only 2
percent of the total number of stop-loss claims from 2014-2017, but
about 20 percent, or nearly $600
million, of the total $3
billion in stop-loss reimbursements.
- Impact of injectable drugs – In 2017 four of the five costliest
injectable drugs, used to treat cancer or related conditions,
accounted for approximately $45
million, or 24 percent of the total $186.3 million spent on injectable drugs that
year.
- Looking to the future – Gene therapy is an emerging treatment
gaining more attention and utilization, and may pave the way to
treat costly genetic disorders, such as hemophilia.
- Employers' considerations – Employers have an 85 percent chance
of seeing a high-dollar (stop-loss eligible) claim in any given
policy year.
Employers who self-insure their health plans use stop-loss
coverage to protect themselves from excessive financial losses from
high-dollar claims. Sun Life, the largest independent stop-loss
provider in the country, analyzes its vast database of client
medical stop-loss claims each year to assess industry and health
care trends. Sun Life has over 35 years in the industry and
currently covers 4.2 million lives under stop-loss policies.
About Sun Life Financial
Sun Life Financial is a
leading international financial services organization, providing a
diverse range of insurance, wealth and asset management solutions
to individuals and corporate Clients. Sun Life Financial has
operations in a number of markets worldwide, including Canada, the United
States, the United Kingdom,
Ireland, Hong Kong, the
Philippines, Japan,
Indonesia, India, China,
Australia, Singapore, Vietnam, Malaysia and Bermuda.
As of March 31, 2018, Sun Life
Financial had total assets under management of C$979 billion. For more information please visit
www.sunlife.com.
Sun Life Financial Inc. trades on the Toronto (TSX), New
York (NYSE) and Philippine (PSE) stock exchanges under the
ticker symbol SLF.
In the United States, Sun Life
Financial is one of the largest group benefits providers, serving
more than 60,000 employers in small, medium and large workplaces
across the country. Sun Life's broad portfolio of products and
services in the U.S. includes disability, absence management, life,
dental, vision, voluntary and stop-loss insurance. For more
information, please visit www.sunlife.com/us.
Media contact:
Devon Fernald
Sun Life Financial
781-416-7151
Devon.portney.fernald@sunlife.com
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SOURCE Sun Life Financial