TELUS Health 2024 Drug Trends Report: Diabetes medications maintain top reimbursed expense position; ADHD drugs surge

Expansion of biosimilar switching policies persists as plan sponsors seek to improve how they manage costs for specialty drugs

TORONTO, April 23, 2024 /CNW/ - TELUS Health revealed today the results of its 2024 Drug Data Trends and National Benchmarks Report at its 20th annual TELUS Health Conference, running today and April 30. Diabetes medications remain the leading drug category for eligible private insurance claims for the second consecutive year and noteworthy spikes were observed in claims for attention deficit hyperactivity disorder (ADHD) medications, particularly among young adults. In the specialty drugs space, the expansion of biosimilar switching policies persists as plan sponsors seek to improve how they manage costs for these medications.

"Private drug plans are a highly valued and necessary offering, not only for talent attraction and retention, but also for workplace productivity," said Martin Bélanger, Senior Vice-president, Payor & Provider Solutions, TELUS Health. "By actively contributing to Canada's health insurance and prescription medication space with initiatives like this report, we look to stay true to our commitment to power a healthier future by helping people in Canada live healthier and happier lives."

Health Canada reports that over three million people in Canada, 8.9 per cent of the population, have diabetes, with a yearly prevalence growth of 3.3 per cent. The growing prevalence of diabetes, along with expanded heart failure treatment indications and continued potential for off-label use for weight loss, led to a 29.4 per cent increase in eligible claim amounts for diabetes medication over 2022 putting it first on the list of the top four most frequently reimbursed drug categories under benefits plans in Canada.

Rounding out the top four drug categories are:

• Inflammatory diseases, like rheumatoid arthritis
• Skin disorders
• Attention deficit hyperactivity disorder (ADHD) - These medication claims rose to fourth in 2023, driven by growing awareness of the disorder's impact, especially among young adults. Since 2008, the number of claimants for ADHD medication has multiplied more than eight-fold.

Diabetes, ADHD, depression, weight management and women's health are five categories to watch in the coming years due to their expected impacts on the drug-plan spend as well as personal health and productivity.

"The growing prevalence of type 2 diabetes, along with the fact that nearly 6.1 per cent of adults in Canada have prediabetes, indicates that eligible claim amounts are likely to increase in the coming years," explains Vicky Lee, Pharmacist and Pharmacy Consultant, TELUS Health. "Further, the proportion of patients starting treatment with two-drug combinations has almost doubled in the past few years, contributing to higher overall costs."

Specialty drugs' share of the total eligible claim amount plateaued in 2023, a reflection of the impact of public- and private-sector switching policies for lower-priced biosimilar drugs. Specialty drugs' share of the eligible claim amount was 31.2 per cent in 2023, down by more than a percentage point compared to 2021. Savings driven by biosimilar switching policies are likely to continue for some time as more plans adopt switching policies and more reference biologics go off patent.

"Biosimilars continue to offer a significant opportunity for cost savings for private payors," adds Caroline Le Pottier, Pharmacist, TELUS Health. "With Ontario being the most recent province to implement a biosimilar switching policy, which came into effect on March 31, 2023, we will likely see even more savings for payors reflected in next year's report."

• Employees submitted an average of $1,262 in eligible claims to private drug plans:
  • Western Canada reports an annual eligible amount of $905, a 69.1 per cent decrease from the highest regional average of $1,530 in Atlantic Canada. The lower amount in the West is influenced by provincial Pharmacare or universal drug plans in British Columbia, Manitoba and Saskatchewan, which become the primary payor after the out-of-pocket deductible is met.
  • Atlantic Canada consistently leads in annual eligible amounts due to a higher proportion of plan members needing specialty medications.
  • Quebec has the lowest average eligible amount per drug-plan claim at $71.56, attributed to pharmacies dispensing 30-day supplies of chronic medications compared to 60- or 90-day supplies in other provinces.
• Generic medications hold a significant 67.5 per cent share of all prescriptions covered by private drug plans.
  • While generic alternatives are still unavailable for most remaining prescriptions, there is growth potential in specific regions and plans without mandatory generic pricing policies.
  • Approximately 6.6 per cent of medications covered by private drug plans are multi-source brand-name medications with available generics, indicating room for further general utilization.

Including data dating back to 2008, the report analyzes major trends in private drug plan costs, utilization, and benefits plan management, assisting the insured benefits industry to adapt to ever-changing environments. The analysis for this year's edition is based on data found within the 2023 TELUS Health portfolio, using claim activities of more than 15 million insured people in Canada throughout 2023.

TELUS Health is a global healthcare leader providing comprehensive primary and preventive care services and solutions to improve physical, mental and financial wellbeing for employees and families worldwide. With our advanced technology and dedicated team members, including more than 100,000 compassionate health professionals, we are covering nearly 70 million lives in 160 countries. We are on a mission to become the most trusted wellbeing company in the world by building the healthiest communities and workplaces on the planet through simplifying access to care and improving the flow of information between care providers, insurers, employers and individuals. For more information please visit: www.telushealth.com.

For media inquiries, please contact:
Marielle Hossack
TELUS Health
[email protected]

SOURCE TELUS Health