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June 15, 2023
Diabetes is now top drug claims category in Canada
Diabetes (12.9 per cent) was the largest drug claims category by eligible amount in 2022, according to a report from Telus Health.
Diabetes overtook rheumatoid arthritis (11.2 per cent), which fell to second in the rankings. And its impact on drug plans could be bigger in the future, according to the report.
“The fact that growth in spend has been observed in a specific diabetes class of drugs suggests that existing claimants are switching to more costly therapies,” said Lavina Viegas, pharmacist, TELUS Health. “My prediction for the future of the diabetes category is that there will be continued growth, especially with more products slated to hit the market that have shown good clinical efficacy in both diabetes and weight loss.”
Completing the top 10 are:
• Skin disorders (third at 8.1 per cent)
• asthma (fourth at 5.3 per cent)
• depression (fifth at 5.2 per cent)
• ADHD/narcolepsy (sixth at 5.1 per cent)
• cancer (seventh at 3.8 per cent)
• multiple sclerosis (eighth at 3.0 per cent)
• high blood pressure (ninth at 2.5 per cent)
• gastrointestinal claims (10th at 2.5 per cent)
From 2019 to 2021, the volume of mental disorder drug claims among those aged below 30 rose by 24 per cent, according to Sun Life.
Total eligible amount for traditional drugs rose 8.9 per cent in 2022 while the increase for specialty drugs was 6.5 per cent, according to Telus Health’s 2023 Drug Data Trends & National Benchmarks report, which captured claims data for more than 4.6 million cardholders in 2022. This is the first time in more than 10 years that the growth rate for specialty drugs fell behind that of traditional drugs.
Year Specialty drug growth rate Traditional drugs growth rate
2022 6.5 per cent 8.9 per cent
2021 8.6 per cent 2.1 per cent
2020 10.6 per cent 1.8 per cent
2019 16.8 per cent 9.8 per cent
2018 8.7 per cent 0.0 per cent
2017 10.5 per cent 1.4 per cent
2016 9.6 per cent 3.5 per cent
2015 19.5 per cent 3.7 per cent
2014 20.5 per cent 2.4 per cent
2013 12.3 per cent -1.1 per cent
Growth in spending
Growth in spending by private drug plans remained moderate in 2022, according to Telus Health.
Looking at the average monthly amount of drug costs eligible for coverage spread out across all certificates, the growth rate was 2.6 per cent in 2022 – lower compared to the 3.2 per cent growth in 2021 and 2.8 per cent in 2020.
In dollar terms, the average monthly eligible amount per certificate was $103.30 by the end of 2022 – up from $100.73 in 2021 and $97.58 in 2020.
The number of claims per person was 10.8 in 2022 – slightly lower compared to 11.4 claims by the end of 2020. It hovered around 10 claims annually between 2014 and 2019.
The growth rate in eligible amount for plan members under 25 years old was 14.2 per cent in 2022, more than double of that of plan members aged 60 to 64 (6.2 per cent) and 50 to 59 (5.4 per cent).
In 2021, there was a noticeable increase in the number of claims for mental health-related medications during the second year of the pandemic. Also, health claims for drugs used to treat depression increased by 10 per cent for adults and 22 per cent for dependants in 2020 in Canada, according to previous reports.
June 23, 2023
Disability advocates get their wish as the Canadian Disability Benefit Act Bill C-22 is passed
Disability advocates finally got their wish after federal government passed the Canadian Disability Benefit Act Bill C-22 just before the House of Commons prepared to adjourn for the summer.
Despite garnering support from all major political parties, the bill, aimed at reducing poverty and ensuring financial security for people with disabilities, had remained relatively unnoticed within Parliament for the past two years.
The bill was initially tabled in 2021 and introduced in June 2022, undergoing several amendments before reaching the Senate for consideration.
The Bill will establish the first federal income supplement specifically for working-age Canadians with disabilities. This supplement will complement existing provincial and territorial benefits and provide a tax-free monthly payment to low-income individuals with disabilities under the age of 65.
In an interview with the Edmonton Journal, Don Slater, an advocate for the Edmonton disability community who himself lives with a disability, emphasized the bill will lift many disabled individuals above the poverty line, a threshold that currently eludes them.
“This would allow a disabled person to achieve a state of wellbeing because they’re no longer trading off one commodity for another,” said Slater.
Currently, the bill is under review in the Senate, where a series of amendments are being examined. One rejected amendment sought to prevent controversial clawbacks of benefits from insurance providers, which were deemed unconstitutional. Slater and other community members asserted that eliminating clawbacks is crucial for ensuring that those in need receive the financial assistance they require.
Jason Nixon, Minister of Alberta Seniors, Community and Social Services, expressed the province's support. However, he emphasized the need for detailed discussions with the federal government to determine the potential impacts on Albertans and provincial programs and services.
“Alberta is calling for the federal government to come to the table with all provinces and territories on the details of this program,” Nixon told the Edmonton Journal.
With time running short before the House of Commons adjourns, concerns were mounting among advocates like Zachary Weeks, a board member of the Voice of Albertans with Disability in Edmonton. Weeks feared that without the bill's passage, individuals with disabilities will continue to fall through the cracks, sinking further below the poverty line.
“It’s very difficult (for members of the community),” Weeks told the Edmonton Journal.
“They’re living hand to mouth. Across the country, groceries and bills have gone up and yet the amount that they are given to live on is not going up. The gap is widening.”
After Friday, the House of Commons will adjourn and is not scheduled to reconvene until September 18.
June 27, 2023
Canadian Association of Optometrists releases vision care handbook
The Canadian Association of Optometrists has released its 2023 Vision Care Benefits Handbook: The Case for Modern Coverage.
“The Handbook is a valuable companion guide for group benefit stakeholders responsible for designing and administrating vision care plans. It clarifies the role of modern diagnostics tools in the early detection, monitoring, and management of serious eye diseases that can lead to vision loss,” says François Couillard, chief executive officer of the Association.
The Handbook outlines the impact of prevalent eye diseases, not only on vision but on the overall health and quality of life of working Canadians and their families. It also outlines a path to remedy some of the existing gaps in vision care benefits.
This is an exciting time for vision health, says Couillard. Private Member’s Bill C-284, ‘An Act to establish a National Strategy for Eye Care’ has passed its second reading in parliament with unanimous consent. It is expected to be signed into law before the end of the year.
June 28, 2023
Canada's drug regulation shift raises concerns over access and healthcare budget
The Canadian government has introduced a new regulatory framework called "Agile Licensing" to speed up the pre-market regulation process for pharmaceuticals. While Health Minister Jean-Yves Duclos claimed that this initiative aims to provide Canadians with "access to quality and affordable medicines", experts warned that the policy could have harmful effects.
If adopted, the Agile Licensing system would enable companies to bring drugs to market up to six months earlier than the current process allows. This would entail fewer pre-market clinical trials, with the condition that companies continue studying the drugs' effectiveness once they are available to the public.
While the government argued that this approach would improve the quality of life for Canadians, estimating an improvement value of $302 million over ten years, critics point out flaws in the underlying assumptions of this estimate.
Canada will have less information about the risks associated with new medicines if these drugs enter the market with reduced pre-market clinical data. This could become problematic if companies fail to conduct promised post-market studies or if Health Canada does not promptly remove unsafe or ineffective medications from circulation.
Fast-tracking the approval of new medicines is not only potentially wasteful, but it will also divert funds from other areas in the healthcare system to cover the costs of expensive, yet unproven drugs.
New medicines have been the primary driver of increasing prescription drug spending in both private and public drug plans.
Rather than simply replacing older medications, new drugs contribute to an overall rise in the drug budget, resulting in missed opportunities to allocate those funds to other crucial healthcare sectors, such as improving access to joint replacements, nursing homes, or mental health care.
Contrary to the Minister of Health's assertions, the proposed framework lacks mechanisms to ensure the affordability of fast-tracked medicines. This raises concerns, considering that the drugs eligible for expedited approval are often patented and specialized, likely to be priced at unaffordable levels.
Patents, although intended to foster innovation, can also grant manufacturers of specialized medicines the power to charge excessively high prices due to the life-or-death situations faced by patients in need of such treatments. Pharmaceutical companies have increasingly capitalized on this market power.
Before 2006, only four drugs approved in Canada had annual prices exceeding $50,000 per patient. This number has risen to 67, costing Canadians over $3 billion a year.
Higher drug prices do not guarantee improved value or better health and well-being.
Studies show that in healthcare systems similar to Canada, it typically costs around $30,000 to achieve a measurable improvement in an individual's health for one year. Many new patented medicines often require hundreds of thousands of dollars for the same benefit.
This disparity between reasonable prices for health benefits and the costs of patented medicines suggests an inherently flawed system.
It directly impedes Canadians' access to necessary treatments due to unaffordable prices and indirectly diverts funds away from more investments that could yield greater health benefits per dollar spent.
Policymakers must develop and enforce measures to ensure drug prices remain within reasonable limits before prioritizing fast-track approvals to boost sales, critics suggest. Unfortunately, the Canadian government recently stepped back from reforms that could have addressed this issue.
