Sun Life has published a study of its drug plan trends and trends in paramedical services usage by group benefits claimants over a six-year period, spanning before and after the COVID-19 pandemic. The research shows more plan members are making use of their benefits and they’re claiming significantly more today than they have been in the past.
Massage therapy remains the most utilized benefit, followed by physiotherapy. Perhaps not surprising to some, the report also notes surging mental health practitioner claims, as growth in this category was most significant, more than tripling over the 2019 to 2025 study period. All other paramedical categories experienced a dip in usage.
“Mental health practitioner claims have increased 3.5 times since 2019, while the proportion of plan members making a mental health practitioner claim increased approximately 2.5 times,” Sun Life’s representatives state in an email exchange with the Insurance Portal.
Growth in mental health claims is leveling out somewhat through 2025, the report adds, but the proportion of plan members claiming is still rising, especially among those under 30.
Chronic disease
They also note that growth across four major chronic disease drug categories was two to three times higher among plan members under 30 than among other age groups in recent years.
Erin Crump, SunLife Health’s vice president of market development, also in an email exchange with the Insurance Portal, says although incidence remains lower than among older cohorts, claims across chronic disease categories including asthma/COPD, diabetes, high blood pressure and high cholesterol are growing two to three times faster among plan members under 30.
“I wouldn’t characterize this as evidence of a health crisis among plan members under 30. What it could reflect is earlier diagnosis, greater awareness and greater willingness to seek care,” she adds, noting that lifestyle factors may also be playing a role. “It’s encouraging that younger Canadians appear more willing to access support when they need it. It also tells us and employers that health needs and benefits use are evolving and that prevention, navigation and appropriate support across all age groups is increasingly important.”
She also adds that the company’s research suggests that managing health is more complicated today than it was five years ago. “Canadian’s health needs and the ways they access care continue to evolve.”
Paramedical claims
Overall, they say growth across paramedical claim categories is almost entirely due to an increase in the number of plan members making claims. The same is true for growth in drug claims observed. “Almost all growth was driven by the fact a higher proportion of plan members were making claims,” the report states.
Based on data from over 20,000 employer groups, the Designed for Health paramedical and drug claims trends report shows that plan members are now claiming significantly more for paramedical treatments than they were pre-pandemic.
Drug plan claims, meanwhile, remain the highest for high blood pressure and diabetes medications, followed by claims for drugs treating high cholesterol and depression. The report also notes a decline in claims for painkillers as opioids are today being prescribed with more caution in Canada.
The report looks in some detail at several categories of high utilization, high growth drugs, including those for cholesterol, diabetes, depression, chronic weight management, ADHD and hormone replacement. Among the points of interest, they say digital diabetes coaching may cut the use of intensive diabetes drugs by half over a 10-year period.
“Canadians are dealing with more complex health needs, particularly mental health and chronic conditions. At the same time, greater awareness, reduced stigma and options like virtual care are making it easier to reach out for support,” Crump says. “The goal is to make the path from knowing support exists to accessing it as simple as possible.”
