2021 TELUS Health Drug Data Trends & National Benchmarks report

While COVID-19 clearly affected claims patterns for private drug plans in 2020, its net impact was, perhaps surprisingly, relatively minimal. For example, on the one hand claims for maintenance medications spiked during the early months of the pandemic due to Canadians’ efforts to stockpile as well as governments’ counterefforts to protect the drug supply. On the other hand, claims for acute medications declined sharply due to delayed surgeries and far fewer visits to physicians’ offices.

The growth rate for total eligible drug costs for all insureds is not remarkably higher or lower than results for the previous four years. It can also be described as “pandemic-proof,” given the deflationary trend experienced by many other areas of consumer spending in 2020. On a cost-per-claim basis, growth was more than three times the average rate of increase of the consumer price index last year. 

Data for the 2021 report was extracted from the TELUS Health database of nearly 13 million insured individuals and 150 million prescription drug claims. It is divided into four main sections: costs & utilization, specialty drugs, drugs by therapeutic class and plan management. 

Highlights include:

• Claims for drugs used to treat depression increased by 10% for adults and 22% for dependents in 2020. 
• For 20-39-year-olds, the number of claimants for antidepressants climbed from 5.6% in 2016 to 7.9% by the end of 2020.
• Antidepressants rose from seventh to fourth as the most prescribed medications in Canada in 2020. 
• At 3.8%, the growth rate for monthly eligible costs for all insureds has settled back down to “pre-OHIP+” levels. In 2018 and 2019, OHIP+ in Ontario had a significant impact on cost trends.
• The growth rate for costs for specialty drugs was more than six times that of traditional drugs.
• Fewer insureds made a claim: 57.3% in 2020, compared to 63.1% in 2019. However, among those who did, the average number of claims per claimant increased by 11.7% (from 10.3 claims to 11.5 claims).
• The average cost per claim was $76.52, an increase of 2.3% over 2019. While this is comparable to previous years, it is three times the growth rate of the consumer price index, which dropped to just 0.7% in 2020 due to declines in consumer spending.
• Specialty drugs’ share of eligible costs climbed by two points to reach 32% of total costs, for only 1.3% of claimants. Private plans in Atlantic Canada are most impacted, as 40% of eligible costs are for specialty drugs.
• B.C.’s switching policy for biosimilar biologics has benefited private plans: by the end of 2020, biosimilars’ share of eligible costs had more than quadrupled, to 70%, since the government’s policy was implemented in May 2019.
• The top therapeutic areas based on eligible costs continue to be rheumatoid arthritis, diabetes and skin disorders. The categories for rheumatoid arthritis and skin disorders are dominated by specialty drugs (99% and 62% shares, respectively).
• The pandemic caused claims for anti-infectives to plummet, enough for the category to drop off the top-10 list.
• In June 2020, claims for maintenance medications were 32% higher than in June 2019, a reflection of governments’ efforts to protect the drug supply by limiting amounts dispensed for refills.
• Claims for hydroxychloroquine, briefly considered as a possible treatment for COVID-19 until evidence proved otherwise, increased by 21% during the second quarter of 2020.
• 56% of certificates have plans that include mandatory generic substitution policies, unchanged from 2019. Generic drugs now account for 64% of prescriptions dispensed to private drug plan members, up from 60% five years ago.