2021 BPS coverage: Drug, disability claims stabilizing but pandemic’s impact lingers

Read: Private drug plan spending rose 5.4% in 2020: report

As the majority of provinces set temporary 30-day supply limits on prescriptions to prevent stockpiling, this spike in claims was followed by a significant drop in prescription durations and a second wave of claims growth, as patients renewed their prescriptions more often. “Converting from 90-day to 30-day supplies resulted in additional claims and dispensing fees, but from a plan sponsor perspective, the pandemic had a modest impact compared to 2019.”

While public health measures such as physical distancing caused claims for cold medications and antibiotics to decrease by 51.9 per cent and 22.5 per cent, respectively, plan sponsors saw an increase in drug claims related to depression (11.6 per cent), diabetes (10.6 per cent), high blood pressure (13.4 per cent) and high cholesterol (14.8 per cent). Antidepressant claims jumped among plan members aged 18 to 44 due to factors such as increased stress, decreased socialization and poor work-life balance. “We encourage plan sponsors to monitor the mental health of plan members and to mitigate the impact of the pandemic on mental health,” said Leblanc. “We’re hoping for a return to normal life and regular use of antidepressants.”

Read: How plan sponsors can contain rising drug costs in 2021

While drug claims rates in 2021 are returning to their normal volumes, there’s also a backlog of Canadians seeking medical treatment, he said. These include about 100,000 Canadians seeking treatment for depression, as well as 20,000 diabetes patients and 10,000 cancer patients.

At the beginning of the pandemic, there was also a drop in short- and long-term disability claims, attributable to factors such as company shutdowns, paid leave and government support, said Cheryl Nicholson, manager of group life and disability at iA Financial Group. Among the STD claims made at the pandemic’s onset, the average length was two weeks, in line with the typical recovery period associated with the coronavirus.

Early in the pandemic, she noted, there was a slight increase in the duration of disability claims across all conditions, related to the stoppage of treatment programs and surgeries, as well as limited access to physicians for medical followups. This also resulted in reduced usage of extended benefits and slight reductions in rehabilitation and medical costs.

Read: How will the coronavirus impact long-term disability claims?

Although the number of STD claims related to the pandemic began climbing again during the second wave, the amount of claims related to other conditions has stabilized. While there hasn’t been an overall increase in disability claims related to mental health — despite an increase in antidepressant use over the last year — Nicholson said more plan members are reporting increased anxiety amid the pandemic’s third wave, contributing to work-avoidance behaviours.

And among so-called long-haulers — individuals who display coronavirus symptoms for months following infection — there will be increased demand for rehabilitation providers and insurers over the coming months. iA Financial Group is using available medical evidence and taking an “individualized approach” to these claims, she said.

“While long-haul symptoms are real, they might not always represent a total impairment or inability to work. A lot depends on the individual case and the research that’s being conducted to unravel the mystery of COVID long-haulers and provide us with management protocols.”

Read: Taking the long view on effectively dealing with LTD claims