TELUS Health Drug Report - my top 5 takeaways

The 2022 Drug Data Trends & National Benchmarks report by TELUS Health is a fan favorite filled with useful data. This year's report can be found here

TELUS shares that the growth rates for 2021 and 2020 occurred despite notable declines in the number of insureds who submitted claims during the first two years of the pandemic. So besides drug costs continuing to rise and should continue to be a focused area to reduce claim cost...
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​My Top 5 takeaways are:

1. The average monthly eligible amount per claim jumped by 8.9% in 2021, well above growth rates for the previous 4 years.
2. The average eligible amount is higher for older people compared to younger people. Not a surprise. Put into context through, the amount for insured aged 60 to 64 is 6.6 times the amount for those under age 25. We are seeing an increase in incidents for new diabetes starts in younger people though.
3. There’s savings to be had with generic drugs. Atlantic Canada has the highest utilization of generics at 72% which shows that Ontario at only 63% and Quebec at 60% have a lot of catching up to do. 10% of drugs covered in private plans were multi-source (means generics are available). This is an excellent place for advisors to advice their clients to make this simple cost saving plan change wherever possible. If you do one thing at all, do this.
4. Specialty drugs command a third of the total eligible amount considered for coverage by drug plans, despite a relatively miniscule number of insureds taking these drugs. Their share of private drug plans’ average monthly eligible amount per certificate is expected to reach almost half by 2026
5. Prioritizing biosimilars will save huge dollars. B.C.’s policy of switching patients on originator biologics to lower-cost biosimilars has had a huge impact on private plans. The savings were immediate and by the of 2021, the relative eligible amount per claimant in B.C. for a biologic was two-thirds (66%) what it had been in January 2019. That’s HUGE savings.

It’s worth noting that Not all carriers followed suit to mimic the government’s switching policy in order to avoid taking on the full cost of originator biologics for plan members who choose not to switch and instead turn to their private plan for coverage. In addition to paying the full cost of a plan member’s claim, it also opens the Employer/Plan Sponsor to COB risk.

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