The cost of specialty prescription drugs to treat conditions like cancer and hepatitis has doubled over the past decade, according to the Express Scripts Canada Drug Trend Report released May 3.
The report, which analysed prescription drug claims from millions of Canadians, “shows that private plan spending increased again in 2016 and that rising drug costs, particularly related to high-cost drugs and high-cost patients, undermine the ability of employers to continue to offer a prescription drug benefit to their employees,” says Express Scripts Canada, a company that provides health benefit management services.
Chronic conditions such as hepatitis C and cancer
The study says spending on high-cost drugs (such as those used to treat complex, chronic conditions such as hepatitis C and cancer) has grown from 13 per cent of total drug spending in 2007 to 30 per cent in 2016.
Another key finding from the report is that 14 per cent of plan members account for 72 per cent of total plan spending and one in five dollars spent on prescription drugs in 2016 paid for medication for diabetes or an inflammatory condition.
Double-digit growth in spending on ADHD medication
The study also found double-digit growth in spending on cancer and attention deficit hyperactivity disorder medications during 2016.
Express Scripts says cancer treatments “dominate the drug development pipeline and a continued shift from hospital-administered drugs (covered by public plans) to self- administered drugs is expected to mean more private-sector claims and higher costs in the future.”
Protecting drug plan sustainability
"More and more employers are limiting employee access to treatment coverage in an attempt to protect drug plan sustainability because they don't understand they have other, better options available to them," observes Michael Biskey, President of Express Scripts Canada."
He suggests that employers can improve overall spending and the sustainability their drug benefit plans by introducing comprehensively managed prescription drug plans. "Employers need to act today to introduce comprehensive managed plans, before cost increases become insurmountable...Focusing plan management efforts on empowering members to make more effective, informed decisions can help fund access to higher-cost specialty drugs when those potentially life-saving treatments are required by employees and their dependents."