A new annual report from TELUS Health reveals that the number of Canadians making claims under their group health benefits plans is at its lowest level in at least five years, but the number of claims per claimant was noticeably higher in 2020 compared to previous years. Eligible costs, utilization and cost per claim, meanwhile were relatively unchanged when compared to earlier years.
“Eligible costs, utilization and costs per claim are essentially pandemic proof. By the end of the year, none of these measures were remarkably higher or lower than previous years,” write authors of the 2021 Drug Data Trends & National Benchmarks Report from TELUS Health. “Specialty drugs are the main factor behind the unremitting forward momentum in cost trends,” they add, saying the medications account for 32 per cent of all costs for just 1.3 per cent of claimants in 2020.
Database of more than 150-million drug claims
The report draws on a database of more than 150-million prescription drug claims to examine costs and utilization, specialty drugs, drugs by therapeutic class and plan management. It found that average claims for acute medications, such as antibiotics dropped 22 per cent at the start of the pandemic, while claims for drugs used to treat depression increased by 10 per cent for adults and 22 per cent for dependents in 2020.
Examining specialty drug statistics, the report also found that costs for specialty drugs increased by 8.7 per cent for those between ages 25 and 64, compared to 1.3 per cent for non-specialty or traditional drugs. Quebec saw the highest increase in specialty drug claims at 10.4 per cent, while Western Canada had the lowest rate of growth for specialty drugs at 6.3 per cent. “The growth rate for costs for specialty drugs were more than six times that of traditional drugs,” they write. “If the current trend continues, specialty drugs could account for close to half the average eligible cost per certificate by 2026.”
Finally, while fewer insureds made a claim overall – 57.3 per cent in 2020 compared to 63.1 per cent in 2019 – among those who did make claims, the average number of claims per claimant increased 11.7 per cent, from 10.3 claims to 11.5 claims per year.
