Drug utilization trends are examined in depth in the most recent report from GreenShield, the 2023 GreenShield Administration Drug Trends Report. In it, researchers uncover an overall rise in utilization rates, driven by the use of new therapies.

The fourth annual report, based on data from 32 million claims processed by GreenShield Administration (formerly known as HBM+) over the past year, shows three therapeutic categories that are likely to have a high impact on benefits plans in 2023. These include attention deficit hyperactivity disorder (ADHD) drugs, migraine medications and asthma therapies.

The number of ADHD claimants grew by 15 per cent; roughly six per cent of GreenShield’s claimants were using ADHD medications in 2022. “The report demonstrates a significant increase in the rise in adult ADHD drug expenditures,” they write.

New treatments for migraine patients, meanwhile, have increased existing migraine patient drug costs overall by 132 per cent over the last three years.

Finally, the report also shows an increase in the number of medications claimed that are primarily used for asthma and chronic obstructive pulmonary disease (COPD) treatment. These were claimed by 16 per cent of claimants in 2022. Claims for biologic medications to manage severe asthma grew 13.5 per cent between 2018 and 2022.

“As utilization rates rise, cost concentration appears to be intensifying. The report shows more than 50 per cent of costs attributed to five per cent of claimants, and over 30 per cent of costs attributed to one per cent of claimants. This trend indicates an opportunity for enhanced patient support through strategies such as comprehensive case management provided by specialty pharmacies, and new practices for prior authorization, step therapy, and Product Listing Agreements (PLAs),” they state.

Diabetes represented the second-largest share of drug costs in the top five per cent claimant group, while those suffering from rheumatoid arthritis (RA), Crohn's disease, colitis, and psoriasis “represented the largest share of total drug costs in both the top one per cent and top five per cent high-cost claimant groups.” 

Overall, GreenShield reports that there was an 8.1 per cent growth in total adjudicated drug costs between 2021 and 2022.