Specialty drugs make up a large portion of plan spending

Express Scripts Canada’s largest drug trend report Prescription Drug Trend Report – Trends in Canadian Private Drug Spend has reported that employer-sponsored drug plan spending increased 2.5% from 2016 to 2017.

Specialty medication costs have more than doubled from 15% of total spending in 2008 to 31% in 2017.

While specialty prescriptions represented just 2% of total claims, they made up almost one-third of total drug spending.

The factors driving an increase in spending in this category in 2017 included a greater utilization of specialty medications within common conditions such as asthma and high cholesterol. In addition, spending was driven upwards by the introduction of new high-cost medications, and new indication approvals for existing medications.

Further, this spending is from a small group of claimants. About 20 percent of claimants account for almost 80 percent of the drug spending.

The report also highlighted non-adherence. Among the 20 percent of claimants who account for 80 percent of the drug spending, half are non-adherent to one or more of their medications. Patients who are not-adhering to their medications impacts both the patients as well as the plan sponsor by increasing the drug spend. Helping patients adhere to their medications results in less wastage and better outcomes for patients. Insurance companies are coming up with methods to assist patients in adhering to their drugs, for example RBC’s Drug Compatibility Testing program.

While there are new generic and biosimilar drugs coming on the market to help mitigate the costs of specialty drugs, plan sponsors can also encourage methods to control drug spend such as prior authorization and the use of preferred-pharmacy networks.

Source: Express Scrips Canada Prescription Drug Trend Report – Trends in Canadian Private Drug Spend