While the trend for overall private drugs is up only one per cent, prescription drug benefits continue to be threatened by the growing use of high-cost specialty drugs, says Express Scripts Canada. And it says sustainability depends on innovative solutions that translate into lower costs and improved health outcomes.
“This year’s Prescription Drug Trend Report confirms what we already know: innovative solutions are key to controlling the cost of prescription drug benefit plans, especially at a time when we have entered into an age of million-dollar-per-treatment drug launches. Innovations that deliver potentially breakthrough treatments with astronomical prices require us to be equally innovative in how we manage prescription drug benefit,” Dr. Dorion Lo, president of Express Scripts Canada, said in the company’s 2020 Drug Trend and Utilization Report.
Those with multiple conditions and rare diseases are where high costs lie
Members of drug plans who have a number of health conditions and require different medications face annual drug costs more than 16 times higher than the average drug plan member.
While cancer treatment remains the primary pharmaceutical research focus in development, there are more than 30 new rare disease treatments on the horizon. About one million Canadians live with a rare disease and because they affect so few people treatments are often “immensely expensive.”
Dr. Lo said the industry expects research to focus on producing high-priced specialty drugs, which currently consume more than one-third of all drug spending.
Because of the growing use of these high-cost specialty drugs, the sustainability of benefit plans depends on drugs with both lower costs and better health outcomes, said Lo.
