Private drug plans spending shows moderate bump
Diabetes (12.9 per cent) was the largest drug claims category by eligible amount in 2022, according to a report from Telus Health.
Diabetes overtook rheumatoid arthritis (11.2 per cent), which fell to second in the rankings. And its impact on drug plans could be bigger in the future, according to the report.
“The fact that growth in spend has been observed in a specific diabetes class of drugs suggests that existing claimants are switching to more costly therapies,” said Lavina Viegas, pharmacist, TELUS Health. “My prediction for the future of the diabetes category is that there will be continued growth, especially with more products slated to hit the market that have shown good clinical efficacy in both diabetes and weight loss.”
Completing the top 10 are:
- Skin disorders (third at 8.1 per cent)
- asthma (fourth at 5.3 per cent)
- depression (fifth at 5.2 per cent)
- ADHD/narcolepsy (sixth at 5.1 per cent)
- cancer (seventh at 3.8 per cent)
- multiple sclerosis (eighth at 3.0 per cent)
- high blood pressure (ninth at 2.5 per cent)
- gastrointestinal claims (10th at 2.5 per cent)
From 2019 to 2021, the volume of mental disorder drug claims among those aged below 30 rose by 24 per cent, according to Sun Life.
Total eligible amount for traditional drugs rose 8.9 per cent in 2022 while the increase for specialty drugs was 6.5 per cent, according to Telus Health’s 2023 Drug Data Trends & National Benchmarks report, which captured claims data for more than 4.6 million cardholders in 2022. This is the first time in more than 10 years that the growth rate for specialty drugs fell behind that of traditional drugs.
|
Year |
Specialty drug growth rate |
Traditional drugs growth rate |
|
2022 |
6.5 per cent |
8.9 per cent |
|
2021 |
8.6 per cent |
2.1 per cent |
|
2020 |
10.6 per cent |
1.8 per cent |
|
2019 |
16.8 per cent |
9.8 per cent |
|
2018 |
8.7 per cent |
0.0 per cent |
|
2017 |
10.5 per cent |
1.4 per cent |
|
2016 |
9.6 per cent |
3.5 per cent |
|
2015 |
19.5 per cent |
3.7 per cent |
|
2014 |
20.5 per cent |
2.4 per cent |
|
2013 |
12.3 per cent |
-1.1 per cent |
Growth in spending
Growth in spending by private drug plans remained moderate in 2022, according to Telus Health.
Looking at the average monthly amount of drug costs eligible for coverage spread out across all certificates, the growth rate was 2.6 per cent in 2022 – lower compared to the 3.2 per cent growth in 2021 and 2.8 per cent in 2020.
In dollar terms, the average monthly eligible amount per certificate was $103.30 by the end of 2022 – up from $100.73 in 2021 and $97.58 in 2020.
The number of claims per person was 10.8 in 2022 – slightly lower compared to 11.4 claims by the end of 2020. It hovered around 10 claims annually between 2014 and 2019.
The growth rate in eligible amount for plan members under 25 years old was 14.2 per cent in 2022, more than double of that of plan members aged 60 to 64 (6.2 per cent) and 50 to 59 (5.4 per cent).
In 2021, there was a noticeable increase in the number of claims for mental health-related medications during the second year of the pandemic. Also, health claims for drugs used to treat depression increased by 10 per cent for adults and 22 per cent for dependants in 2020 in Canada, according to previous reports.
