2018 Drug Data Trends & National Benchmarks Report

The story of drug plans is increasingly two-sided: on the one side are higher-cost specialty drugs, which laid claim to 27% of eligible costs in 2017 for just 1% of claimants; on the other side are traditional non-specialty drugs, where annual growth rates for costs are flat or declining, while utilization slowly climbs. Thrown into the mix are new public policies at the provincial or federal level—such as OHIP+ in Ontario, biosimilar adoption measures and lower generic prices—which are having an impact on private plans.

The 2018 TELUS Health Drug Data Trends & National Benchmarks Report captures major trends in private drug-plan costs and utilization, based on 2017 claims data for more than 11 million insured plan members. But that, too, is just half the story. Equally important are trends in drug plan design, also captured in this report. While impressive gains in the adoption of measures such as co-insurance and mandatory generic reimbursement policies have been made, their widespread implementation appears to be stalled.

Other design tools, such as managed formularies and step therapy, remain largely underutilized.