Specialty drugs are accounting for a slightly smaller portion of the total eligible amount for all drug claims, declining from 33.6 per cent in 2021 to 33.1 per cent in 2022, according to Telus Health’s annual drug trends report.
The report, based on claims data from more than 4.6 million plan members in 2022, found the average eligible amount per claim was $85.39 in 2022, up slightly from an average of $83.44 in 2021.
When claims data was analyzed based on plan members’ ages, there was a large difference in average annual eligible amounts per claimant — $490.58 per claimant aged 25 and younger, compared to more than $1,000 for claimants aged 45 and older. The growth rate in eligible amount for plan members aged 25 and younger (14.2 per cent) was more than double that of plan members aged 60 to 64 (6.2 per cent) and aged 50 to 59 (5.4 per cent).
Across Canada, biosimilars accounted for 32 per cent of claims for biologics with biosimilar options, a percentage that increases among claims made in B.C. (64.7 per cent) and Quebec (64.8 per cent). The report noted provincial biosimilars policies have had a ripple effect on private drug plans adopting similar policies.
Diabetes drugs and devices were the top category by eligible amount, accounting for 12.9 per cent of eligible drug costs, up from 12 per cent in 2021. Rheumatoid arthritis drugs accounted for 11.2 per cent of eligible costs, down from 12.6 per cent, likely due to the increased use of biosimilars.
Antidepressants accounted for 19.3 per cent of all claims, up from 15.9 per cent in 2018, due to increased usage of these drugs among plan members aged 19 and younger. Drugs for asthma (5.3 per cent) depression (5.2 per cent) and attention-deficit/hyperactivity disorders (5.1 per cent) also saw higher growth rates in eligible claims amounts due to the growing number of claimants.
“A combination of factors contributes to the surge in spend for traditional drugs,” said Lavina Viegas, director of client service management at Telus Health, in a press release. “Utilization is gradually rebounding since the start of the pandemic and two of the top-10 categories — diabetes and [ADHD] — are seeing very strong growth for drugs that are relatively high-cost compared to other traditional drugs.”