The use of obesity medications among Canadian employer-sponsored benefits plan members has grown substantially, with claims increasing 42 per cent in 2023 and roughly 92 per cent since 2020, according to a new report by Manulife Financial Corp.

The report, based on aggregate claims data, found more women are using obesity drugs than men (79 per cent compared to 21 per cent, respectively). By region, Ontario (61 per cent) far outnumbered other provinces in terms of percentage of claimants. Ontario (55 per cent) also surpassed the national average for percentage of claimants in 2023.

While much of the increase in usage is attributed to the media attention that this class of drugs has received in recent years, it also stems from increased awareness of holistic health during the coronavirus pandemic as well as new research on how obesity impacts individuals’ health, says Pavithra Ravi, Manulife’s director of pharmacy benefits.

Read: Examining the link between cardiovascular disease, diabetes and obesity

“I think there’s more openness to go to a prescriber or a clinician and have these discussions that perhaps there wasn’t before.”

The report found a third (32 per cent) of employees are at risk of developing a chronic condition based on their body composition, noting coverage for obesity drugs could help plan sponsors lower barriers to access and demonstrate their commitment to supporting their employees’ overall health and well-being.

But Ravi says obesity has a correlation with other comorbidities, such as cardiovascular disease and sleep apnea. Indeed, the report noted more than two-fifths (45 per cent) of plan members aren’t getting enough physical activity, 32 per cent aren’t getting enough sleep and 73 per cent aren’t consuming the recommended five or more portions of fruits and vegetables per day, indicating a significant gap in nutrition.

Read: Diabetes medications remain leading drug category for eligible claims in 2023: report

While the greatest drug spend in 2023 was for drugs used to treat immune disorders, such as inflammatory and rheumatologic conditions, and diabetes, the top paramedical spend was for services commonly used to treat musculoskeletal injuries and/or pain and mental illness.

Both mental-health and musculoskeletal issues were the top reasons for short-term and long-term disability claims. The report noted the average age of LTD claimants is 48 years old and more than
half (55 per cent) are women. High usage of these services shows these conditions may be prevalent in the workplace and that employees are looking to their benefits plans for resources to improve their physical and mental health, it said.

Musculoskeletal issues have always been a reason associated with paramedical claims for pain management or a form of treatment. There has been a rise in these claims over the last couple of years that can also be linked back to the pandemic, particularly with the rise of remote working, says Ravi, adding she’s seen an increase in short-term disability claims associated with musculoskeletal health.

“It was great when it started off where we can all work from home, but probably our home [office] setting was not as ergonomically set up as our [onsite] settings were. And because of that, we’ve seen a lot of patients and plan members recognize that . . . they haven’t been moving around [enough or] their desks haven’t been set up the right way. Or it may just be that . . . working from the couch . . . has led to issues for people.”

Read: How remote, hybrid working arrangements are affecting musculoskeletal issues

The report also found the number of individuals submitting claims for medications used to treat substance use disorder grew by 52 per cent since 2020 and 17.2 per cent between 2022 and 2023.

Based on the trends and some of the behaviours seen from a patient level, Ravi believes this upwards tick in substance use disorder treatment claims will continue. While she says the report doesn’t necessarily show causation or correlation linked to the pandemic specifically, the lack of access to some health-care services during the pandemic resulted in some plan members losing access to mental-health care supports that could’ve helped them deal with issues like social isolation. “I think that there have been different coping mechanisms that perhaps weren’t the most positive behaviours adopted by a number of individuals and patients.”

In the post-pandemic era, Ravi says people are starting to seek out available treatments as much as possible. She suggests plan sponsors examine their benefits plan design to ensure it meets the holistic needs of their workforce.

“The demographic of our employees and the industry itself is always changing. The needs of plan members are dynamic, and, as such, it’s really important [that] plan sponsors take the opportunity to re-evaluate . . . [their] plan design and . . . coverage to determine whether it’s meeting . . . plan members’ needs, while being mindful of the plan’s sustainability.”

Read: Expert panel: Employers taking preventative, holistic approach to employee mental health in 2024