What are five categories to watch for in Canada in the coming years?
Diabetes medications continued to be the leading drug category for eligible private insurance claims in 2023, according to TELUS Health.
Medications for diabetes (15.4%) beat out those for inflammatory diseases (such as rheumatoid arthritis), skin disorders, ADHD and depression, among others, on the list.
“The steady growth reflects the higher prevalence of type 2 diabetes year after year,” said Vicky Lee, manager of pharmacy consulting at TELUS Health. “The explosive growth in 2021 and 2022 is partly due to growing evidence of the effectiveness of second- and third-line therapies for diabetes; as well, off-label use for weight management has contributed to this growth.”
Source: TELUS Health
According to Health Canada, over three million people in Canada, 8.9% of the population, have diabetes, with a yearly prevalence growth of 3.3%.
“The growing prevalence of diabetes, along with expanded heart failure treatment indications and continued potential for off-label use for weight loss, led to a 29.4% increase in eligible claim amounts for diabetes medication over 2022 putting it first on the list of the top four most frequently reimbursed drug categories under benefits plans in Canada,” noted TELUS Health.
Many Canadians need prescription drugs, and most workers have access to employer-provided benefits that allow them to get their hands on these medicines, according to a previous Statistics Canada (StatCan) report.
Top 10 categories for medications
Overall, the average annual eligible amount per certificate in 2023 in Canada was $1,262. The average number of claims per certificate was 15.1 and the average eligible amount per claim was $83.53.
And the top 10 categories by share of total eligible amount made up 62.2% of all claims in 2023, said the TELUS Health report.
Source: TELUS Health
Employers expect a sharp increase of 5.2% in the average per-employee cost of employer-sponsored health insurance in 2024, according to a previous Mercer report.
Growth rates in the total eligible amount were over 20% in the last three years. It had been upwards of 10% in all but two of the past 16 years, according to TELUS Health.
Eligible amounts per claimant
The average annual eligible amount per claimant climbed moderately for most of the 16-year period before it jumped 19.9% in 2023.
“We are probably also seeing a change in prescribing behaviour in response to the new clinical guidelines that recommend double or triple therapy at diagnosis when risk factors or comorbidities are present,” said Lee.
Diabetes, ADHD, depression, weight management and women's health are five categories to watch in the coming years due to their expected impacts on the drug-plan spend as well as personal health and productivity, according to TELUS Health.
TELUS Health will reimburse workers for certain drug prescriptions only if they fill them through the company's own virtual pharmacy, CBC previously reported.
