Understanding what conditions are impacting your plan members and your organization, as well as the resulting cost, is important. Alberta Blue Cross® monitors and reviews drug claiming information to provide insight into the prevalence of health conditions in our populations and the associated costs that can impact plan sustainability in the future.
The following are the top 10 health conditions ranked by total amount paid (Table 1) and by number of claims (Table 2).
Top 10 health conditions based on amount paid*
| Rank | Health condition |
| 1 | Diabetes |
| 2 | Crohn’s disease/ulcerative colitis |
| 3 | Attention Deficit Hyperactivity Disorder (ADHD) |
| 4 | Rheumatoid arthritis |
| 5 | Depression |
| 6 | Asthma/Chronic Obstructive Pulmonary Disease (COPD) |
| 7 | Multiple sclerosis |
| 8 | Cardiovascular disease |
| 9 | Disorders requiring neurotoxins |
| 10 | Skin conditions |
Top 10 health conditions based on number of claims*
| Rank | Health condition |
| 1 | Depression |
| 2 | Cardiovascular disease |
| 3 | Diabetes |
| 4 | Infection (antibotic) |
| 5 | Asthma/COPD |
| 6 | High cholesterol |
| 7 | Reflux/ulcer |
| 8 | ADHD |
| 9 | Allergy (seasonal) |
| 10 | Thyroid disorders |
As can be seen above, there are a mix of conditions at play in the top 10 conditions. Non-modifiable conditions such as Crohn’s disease and rheumatoid arthritis represent higher-cost, lower-frequency claims. By contrast, cardiovascular disease, high cholesterol and diabetes—typically viewed as conditions where the disease severity can be modified—are among the top conditions by number of claims as well as by amount paid.
In 2022, we noted an increase in medications used for the treatment of diabetes and ADHD. The growth in diabetes can be attributed to an increase in the number of members submitting claims and an increase in spend for newer diabetic drugs that have a dual action of blood glucose control and moderate weight loss. Marked growth in this class of medication highlights the importance of effective plan management tools, such as step therapy and special authorization to ensure appropriate use. Rising awareness and changes in the clinical approach of ADHD management has led to an increase in the number of members submitting claims for ADHD. Vyvanse, one of the last medications in this drug class without a generic version, continues to drive spend in this category. Plans with generic pricing in effect can expect some financial relief as a generic medication for Vyvanse will make its way to the market soon.
While lifestyle changes generally have limited impact on non-modifiable conditions, some of the more modifiable conditions noted above can be tackled through education, diet and physical activity. Wellness initiatives, such as the Alberta Blue Cross® Balance® platform, can help. Balance® helps users assess and track their health and wellness habits and includes features like medication and activity reminders and educational articles. The Alberta Blue Cross® care navigation site also provides various health and wellness resources for Albertans and plan members, such as chronic disease management and mental health support, by sharing trusted, reliable services and programs. For more information on this and other resources available to help manage health, please speak with your Alberta Blue Cross® representative.
*The rankings above are based on 2022 Alberta Blue Cross® private plan drug claims data and reflect Health Canada-approved indications (health conditions) of the medications.
Balance® is a registered mark of the Canadian Association of Blue Cross® Plans, an association of independent Blue Cross® plans.
After was running around from doctor to doctor before we finally get rid of her PD ,at age 74 my mother noticed that her handwriting was getting smaller and I was writing faster as well. She also noticed a small tremor in her left hand. The doctor went over her different symptoms and he suspected she either had a small stroke or the beginnings of Parkinson ‘s disease. After finding a neurologist and some testing she was diagnosed with the beginning stages of Parkinson’s disease. That was 3 years ago. She take Sinimet four times a day to control the symptoms, which include falling, imbalance, gait problems, swallowing difficulties, and slurring of speech,This year, our family doctor started her on totalcureherbsfoundation com PD Herbal mixture, 15 weeks into treatment she improved dramatically. At the end of the full treatment course, the disease is totally under control. No case of dementia, hallucination, weakness, muscle pain or tremors.PD or any other disease natural organic remedies are always work on acidity treatment, if we maintain diet plan and use total cure herbs foundation then we get fast relief from this problem.
It is great to hear that she is doing well and experiencing relief! Thank you for sharing 🙂
Can Alberta Blue Cross tell me if they have finally gotten on board with the Libre Sensor approval? Seems every Insurance Company but his one will approve it! if they took the time to do the math, figured out costs of strips, needles on top of the evasive finger pokes how can they not understand this is so much more beneficial for their clients! Come on AB Blue Cross, we expect better than this of you!!!
Hi Lisa,
We can certainly look into whether your plan covers the Free Style Libra sensor. We’ll send you an email to request your plan ID number so we can check this out for you.
Freestyle Libre flash testers save so much money because users use it often,Ontario and quebec I believe have coverage,why not Albertans,As a 4 year user flash testers improve the health of diabetics and do not cost that much more. !
Thank you for your comment Peter, we will share this feedback with our teams.
Exactly! Every other province gets coverage and I pay $300 a month for my plans and was told I will never have coverage for a CGM or FGM system because it’s private insurance so I can only hope for a job with amazing benefits or pay the extra $200 out of pocket for them.. how is a single family income supposed to sustain $500 a month on medical alone?
It’s insane that the Libra system sensor monitoring is not covered under Blue Cross while so many other insurers cover the use of the sensors….the benefits of keeping blood glucose levels within a healthy range by regular monitoring your blood and adjusting diet accordingly has to far out weigh the extra costs of doctor and hospital treatments when levels are often out of range because the patient has no idea what they are [or what food are most detrimental]….isn’t it a fact that prevention is much cheaper than constantly treating a person who has out of range blood glucose levels in both the short term and long term ?
Hi Dan. We appreciate your feedback and will pass this on to our team.
Shall be grateful to know if Dexcom G6 CGM sensors are covered under your Insurance policy, or alternatively Libre 2 sensors? Needless to say CGM’s prevent expenses on blood glucose testing strips. In addition, better management & control of blood glucose prevents patients from developing other serious stages, thereby helps in mitigating expenses.
After being prescribed (due to side effects from common Metformin) a different Metformin was told my AB Blue Cross would not cover it. As a senior who worked in the medical field for 47 yrs was very disturbed hearing this and would have to pay for it myself. Not sure why Blue Cross will not cover it when other provinces do.