In 2023, diabetes medications remained the leading drug category for eligible private insurance claims for the second consecutive year, according to Telus Health’s annual drug trends report.
The report, based on claims data from more than 15 million plan members in 2023, found 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 compared to 2022.
Inflammatory diseases like rheumatoid arthritis were second on the drug category list, followed by skin disorders. Noteworthy spikes were observed in claims for attention-deficit/hyperactivity disorder medications, particularly among young adults, putting them in the fourth spot. Since 2008, the number of claimants for ADHD medication has multiplied more than eight-fold.
Read: 2023 BPS coverage: Diabetes, asthma, ADHD account for high drug claims in 2022
Generic medications held a significant share (67.5 per cent) of all prescriptions covered by private drug plans, while roughly 6.6 per cent were multi-source brand-name medications with available generics, indicating room for further general utilization.
Specialty drugs’ share of the eligible claim amount was 31.2 per cent in 2023, down from 33.1 per cent in 2022. According to the report, 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.
Employees submitted an average of $1,262 in eligible claims to private drug plans in 2023. Western Canada reported an average annual eligible amount of $905 — a 69.1 per cent decrease from the highest regional average of $1,530 in Atlantic Canada. Quebec had the lowest average eligible amount per drug plan claim at $71.56.
“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 of payor and provider solutions at Telus Health, in a press release. “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.”
Read: Specialty drugs accounting for smaller portion of total eligible claims amount: report