In this episode of I read it so you don’t have to but you probably should anyway is the TELUS Health 2024 Drug Trends.

A fan favorite event, I sadly missed the presentation because I was cohosting my company town hall. Worth it, it was legendary.

Remember that 2024 is missing the data from Sun Life due to the PBM switch. Let’s get into it. My top takeaways are:

The avg annual eligible drug amount per CERTIFICATE in 2023 was
Canada $1262
West $905
ON $1377
Quebec $1481
Atlantic $1530

The avg eligible claim was $83.58. If we look back this number has increased quite a bit:
2017 $71.74
2020 $76.63
2021 $83.45 

Big post COVID jump. These is where GLP1s started to hit the market in an impactful way.

Going back to the avg annual eligible drug amount per cert we see the West is sooooo much lower then the rest of Canada. Pharmacare works. Remember that the eligible amount isn't what's paid, it what was eligible for reimbursement before the plan design element kicks in.

The impact is that clients in the east need to set aside more premium for the drug plan. This puts pressure on other parts to the plan, and makes cost containment options like biosimilar first strategy and GLP1 PA all the more appealing.

Nationally generic utilization was 67.5% This is your cue to check that your clients’ plans are set up with the lowest cost alternative & a drug card.

58.7% of people made at least one claim. In 2021 it was 56.3%The avg number of claims/cert was 15.1. In 2021 it was 11.1. More people are claiming, more claims per claimant and a higher cost per claim = a lot more spent on drugs.

The avg age of insured has remained almost unchanged since 2008 ranging from 41-43. This isn't a surprise when you look at who makes up the working population.

Specialty drugs still account for the largest position claims with 1.8% of claimants accounting for 31.2 % of claims. 16yrs ago they accounted for 10% of claims. This has begun to level out a tad partly due to biosimilars, pharmacare and partly because of the highish cost drugs that for common conditions. With the $3-9K category increasing, this pattern will begin to slowly shift. We may even see high cost specialty drugs % of overall claims drop. Drug risk is not just high cost drugs anymore, the abundance of $3-9K drugs are putting pressure on plans.

The top therapeutic class is a lot of the usual suspects. But the introduction of a CF drug pushed that into the #9 spot this year. Diabetes is #1 & probably will be for some time. Inflammatory diseases are #2. This is RA, Chrome's etc and make up a good portion of the high cost specialty spend.

It's interesting too look at the 2008 data. This was prebiologics and a lot of the treatments we have today that are so impactful to people's lives were not available and pooling thresholds were still under $5000. In 2008 the top 5 was diabetes, depression, blood pressure, ulcers & cholesterol.

The full Telus report can be accessed at https://read.uberflip.com/i/1519444-telus-health-drug-trends-report-2024-en/0?