The volume of claims for antidepressants in 2020 is set to exceed 2019 numbers by a significant margin, says pharmacy benefits manager, Express Scripts Canada. The company also says drug classes most affected by the pandemic include treatments for respiratory ailments and infections.

Most notably, Express Scripts Canada says drug claim volume for antidepressants reached 97 per cent of 2019’s total claims before the end of August 2020. More, claims for antidepressant medications from new claimants saw a 20 per cent increase as of August 31. Quebec and Newfoundland saw a higher than average incidence of people being diagnosed and treated for mental health issues, as Quebec was hit earliest, and possibly hardest by the COVID-19 virus. “Newfoundland has been hit hardest, by far, economically,” says Dr. Dorian Lo, president of Express Scripts Canada. “We are seeing these correlations. We unfortunately expect the mental health epidemic to continue with the COVID pandemic. It will continue longer than the COVID-19 pandemic.”

Of the other two drug classes most affected, the company says claims for anti-infective drugs experienced a steep decline during the lockdown as better hygiene practices lowered the transmission of other infectious diseases, but also as fewer people visited their doctors for ear infections or the common cold. Claims for asthma or COPD (chronic obstructive pulmonary disease) drugs meanwhile, saw the greatest increase in volume and value of all therapeutic categories. Although controls were put in place to prevent stockpiling, Lo says there was a certain amount of “allowable stockpiling” which likely occurred as people prepared for self-isolation. “People were appropriately getting inhalers as a bit of a precaution, making sure that they had more than one inhaler around,” he says. Although there was a shortage of rescue inhalers in Canada, he says the supply in Canada is now about the same as it was before the pandemic.

Overall, Express Scripts says claims volumes fluctuated as employees moved from the transition period before provincial lockdown orders were put in place, during self-isolation when schools and public spaces closed to support social distancing and in the re-opening phase as lockdown orders were relaxed. During the transition period, claims increased 14 per cent compared to 2019 numbers, as members stockpiled medication in preparation for self-isolation. During self-isolation, claims volumes decreased six per cent, before increasing five per cent relative to 2019 numbers in the re-opening months of the year.

Although it’s too early to tell what effect the pandemic will have this year on plan sponsors, Lo says the claims experience is only projected to increase by a few percentage points. “In general, the claims experience goes up by one or two per cent (each year),” Lo adds. “This year, although we have not come up with an official figure, it could be in the three to four per cent range.”