Claims for medications treating mental-health issues like anxiety and depression reached 97 per cent of 2019’s total claims volume by the end of August 2020, according to new data from Express Scripts Canada.
In addition, 2020 has seen a 20 per cent increase in claimants for medications relating to depression compared to 2019.
“For the remainder of 2020, there will be a heightened awareness on employee well-being,” said Laura Blair, director of sales for Express Scripts Canada, in a webinar hosted by the pharmacy benefits manager on Wednesday. “Depression is a condition that generally requires longer-term treatment, so these claims will persist and employers will need to consider holistic approaches to care.”
Looking at claims by week since the beginning of 2020, there was no large spike in claims for mental-health drugs, but rather “smaller waves . . . of new users that continued through the self-isolation phase [of the pandemic] and into the re-opening,” said Erica Hatherly, Express Scripts Canada’s senior manager of clinical services. “This might speak to the fact that depression has an enduring effect as it relates to the longevity of that self-isolation phase.”
Younger claimants, specifically those between the ages of 20 and 35, had the largest increase of new claimants for depression medications, said Hatherly. However, the data showed no notable difference between male and female claimants, speaking to a broader acceptance of talking about mental health and seeking treatment.
Quebec and Newfoundland and Labrador saw the largest change in the number of claims for drugs used to treat depression. “There are a few factors we could consider there — Quebec was especially hard hit early on and had a significant impact on [its] long-term care system,” said Hatherly. “We also know that other factors contribute significantly to mental health, including financial and workplace stability, and those could also work into those differences that we saw.”
The pandemic has also had a significant impact on claims for asthma and chronic obstructive pulmonary disease medications, according to the data. Supplies of salbutamol, which is used to treat both conditions, were allocated to hospitals, forcing manufacturers to deliver minimum quantities to pharmacies, which Blair said caused a domino effect. “The announcements of salbutamol shortages could have led to stockpiling by those patients with an asthma diagnosis.”
A look at week-by-week claims data showed a high peak in new claimants for asthma medication during the pre-isolation phase in mid-March. “This could be attributed to new users fearing the respiratory effects of COVID-19 or individuals with a mild disease,” said Hatherly.
As for the pandemic’s affect on overall drug trends, the pre-isolation phase of early March drove a 14 per cent increase in claims compared to the same period in 2019, while the self-isolation phase of mid-March to May saw a decrease of six per cent compared to 2019. However, claims rose five per cent during the re-opening phase between May and August.
Similarly, the values of claims were 16 per cent higher in the pre-isolation phase than during the same period last year. During the isolation phase, claims values plummeted 14 per cent compared to the same time period in 2019.
Blair attributed some of the increase in total claims volume and value to stockpiling and to the temporary 30-days supply limit imposed by many provinces. Indeed, dispensing fees in 2020 began diverging from 2019 data in mid-March and have continued on a steady increase.
Between January and June 2020, claimants made 49 per cent of the total claims seen in 2019, which Hatherly said demonstrates that the claims volume has evened out despite the early peak. “There is the potential for stabilization to occur for the rest of the year; however, we are still carefully following events that may influence the trend for the rest of the year.”