Chronic conditions a major cost driver

Chronic conditions a major cost driver

Chronic conditions a major cost driver Escalating drug costs are an ongoing concern for Canadians – not just for individuals, but also for employers and governments. According to the Pharmacare 2020 report, public drug plans account for 42% of all prescription drug costs in Canada, while private plans cover 36%, and individuals not covered by either a public or private plan account for the remaining 22%.

The recently released Express Scripts Canada Drug Trend Report has revealed certain areas where efficiencies could be made – and chronic conditions topped the list. The findings showed that spending on high-cost drugs (those used to treat diseases such as hepatitis C and cancer) has grown from 13% of total drug spending in 2007 to 30% in 2016. The report also revealed that one out of every five dollars spent on prescription drugs in 2016 paid for medication for diabetes or an inflammatory condition.

Addressing the report, John Herbert, director of strategy, product development and clinical services at Express Scripts Canada, identified some of the key reasons drug costs are spiralling in this country.

“A big portion of that is the introduction of new high cost-drugs in Canada and the increased prevalence of drugs for diseases that were previously not treatable with medication,” he says. “There are more medications that are being expanded in their use to treat a broader part of the Canadian population.”

According to the report, a small proportion (14%) of plan members account for a large amount (72%) of total plan spending, suggesting that the insurance industry needs to put more focus on managing these claimants’ care.

“They struggle with knowing which medications are the most cost-effective and clinically effective for their care,” Herbert says. “So there is a huge opportunity for plans to really focus on driving better decisions and empowering those members with more information so they can make a better, more informed decision.”

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