Canadians’ health priorities are shifting as the coronavirus pandemic drags on, as claims for medications to treat mental-health conditions continued to rise in 2020, along with claims for specialty drugs designed to treat rarer, yet increasingly chronic diseases, according to Telus Health’s annual drug trends report.
There were noticeable shifts in the utilization of mental-health and depression medications, says Shawn O’Brien, Telus Health’s principal of health benefits management. Regardless of age, he notes, there’s been a bigger focus on mental health, resulting in stigma surrounding these issues fading and more people open to seeking help and treatment.
Last year, anti-depressants became the fourth most prescribed medications in Canada, up from the seventh spot in 2016, noted the report. In fact, claims for drugs used to treat depression increased by 10 per cent for adults and 22 per cent for their dependants in 2020. And the number of claimants aged 20 to 39 for these medications climbed from 5.6 per cent in 2016 to 7.9 per cent by the end of 2020.
As the coronavirus crisis continues, the extended isolation is taking a toll on people of all ages, including children who’ve been in and out of school over the last year, says O’Brien, noting this is contributing to the rise in usage of mental-health medications.
The report also found that specialty drugs remained the single biggest factor influencing private drug plan management, accounting for a third of overall costs despite being used by just 1.3 per cent of total claimants. Although these drugs treat rare diseases, they’re now becoming available to treat additional chronic conditions, says O’Brien.
Among the most prescribed specialty drugs, according to the report, were those that treat rheumatoid arthritis, which accounted for almost 100 per cent of eligible costs, and skin disorders, which accounted for 62 per cent of eligible costs. Cancer treatments accounted for 79 per cent of eligible costs. “We’re seeing more cancer drugs coming to market and there’s more in the pipeline that will be specialty drugs, too, so we believe that this trend will persist, [leading] to more costs driven by [these therapies].”
The introduction of biosimilar drugs coming to market is providing alternatives to the innovative drugs that are driving such high costs across private plans, adds O’Brien. Some provinces have moved to enact switching policies whereby they only reimburse for biosimilars. Provinces are also moving new starts or treatment-naïve patients to start on those new drugs and switching those on biologics onto the comparable biosimilar drug.
In B.C., which implemented its switching policy in May 2019, the biosimilars’ share of eligible costs more than quadrupled to 70 per cent by the end of 2020. New Brunswick has also implemented a switching policy and plans are underway in Alberta, Ontario and Quebec to do the same. Although this is on the public side, O’Brien says this practice is also trickling down to prescribing habits on the private side.
The report also found that prescription drug claims for acute care medications, such as antibiotics for common infections, saw significant declines at the onset of the pandemic. In April 2020, average claims for these medications dropped by 22 per cent compared to the previous month, and claims for azithromycin, an antibiotic used for common infections such as ear infections and strep throat, dropped by 73 per cent during the second quarter of 2020. O’Brien notes this could be due to people’s unwillingness to seek treatments for common ailments during the pandemic, adding many have been hesitant to go to physicians’ offices or sit in waiting rooms filled with other people.
O’Brien also notes hyper-vigilance with hygienic and sanitary practices, such as hand-washing, along with social distancing, led to less transmission of communicable viruses, such as the flu, which may be another reason for the decrease in use of these medications and antibiotic treatments.
“Claims for acute medications did, however, see a rise toward the latter half of 2020, likely due to more Canadians having access to and using virtual-care services to secure treatment.”