The annual spend per private drug plan member increased by 6.3 per cent in 2022, according to Express Scripts Canada’s annual drug trends report.
Across both traditional and specialty drugs, the increase was primarily driven by a 5.4 per cent rise in plan members making a claim, which reversed the trend seen in 2020 and 2021. “This is reflective of a year where we saw some return to normalcy at work and school,” wrote Dr. Dorian Lo, president of Express Scripts Canada, in the report’s foreword.
The report also found traditional drugs made up 73 per cent of the annual drug spend while specialty drugs made up 27 per cent, a 4.8 per cent increase for the latter. Traditional drugs accounted for 99.3 per cent of claims, which represented a 6.9 per cent increase. In addition, the spend per claim for traditional drugs increased by three per cent, while the spend per claim for specialty drugs was up 4.8 per cent.
In 2022, the top therapeutic classes were inflammatory conditions, diabetes, depression, asthma/chronic obstructive pulmonary disease, high blood pressure, cancer, attention deficit hyperactivity disorder, skin conditions, ulcer reflux and cardiovascular disease.
There was no dramatic rank changes compared to 2021, said the report, noting the top nine therapeutic classes remained unchanged from 2021. However, it found the spend on multiple sclerosis dropped from 10th to 12th place, while cardiovascular disease rose from 12th to 10th place.
“In 2022, we noted increases in the number of claimants for medications used for depression and attention deficit hyperactivity disorder and we continue to see an increased focus on mental-health services,” noted Lo.
This year, the report introduced a new data feature on comorbidities. It analyzed the top three therapeutic classes — inflammatory conditions, diabetes and depression — and then searched each set of claimants for at least one claim in another therapeutic class.
At 22 per cent, the asthma/chronic obstructive pulmonary disease therapeutic class saw the highest increase in claims, driven by a 47 per cent rise in claimants. And at 18 per cent, the diabetes therapeutic class saw the greatest increase in spend, driven by a 10 per cent rise in spend per claims, as well as increases in claimants and treatments, as well as more costly drugs.
Looking specifically at weight loss drugs, the report noted many drug plans still consider obesity a lifestyle choice and exclude coverage for weight loss drugs. As a result, plan members living with obesity don’t have access to effective medications that can help them address this serious condition.
Indeed, the report found 65 per cent of plan members don’t have coverage for these drugs, while the majority of the 35 per cent who have this coverage said they’re limited by maximums. However, it also found weight loss drug spend increased by 9.9 per cent and claimants increased by 7.5 per cent in 2022.
“The concept of health equity is an aspiration that all Canadians have the same opportunity to achieve positive health outcomes regardless of their social, economic, gender identity, demographic or geographic background,” said Lo. “Despite recognition by the World Health Organization and the Canadian Medical Association that obesity is a chronic disease, 65 per cent of plan members do not have prescription drug coverage for obesity medications.
“We must continue to address the social and economic factors that can negatively impact an individual’s access to treatment.”