We monitor the drug benefit landscape, so you don’t have to. Although there are many factors affecting drug costs—some driving them up, others driving them down—overall prescription drug spending continues to be on the rise. Keeping a pulse on the costs and types of drugs coming to the Canadian drug market is important, which is why we’ve created the 2022 drug pipeline white paper. This white paper highlights developments within the Canadian drug pipeline. Our goal is to help anticipate future cost impacts to private plans.
We’ve collected our main findings below. To read the entire white paper, click here.
- Historically, specialty medications were only used by a small portion of the population for the treatment of complex chronic conditions. They often required special storage, administration and monitoring and were expensive, generally costing more than $10,000 annually. In recent years, we’ve seen the use for these drugs expand to common health conditions such as migraines, cholesterol, asthma and atopic dermatitis—a major reason why costs have risen overall.
Rare disease drugs
- When compared to specialty drugs, rare diseases affect an even smaller group and are often life threatening or debilitating. Technological and financial investments in certain rare diseases have led to an increase in effective life-changing therapies and drug manufacturers have continued to invest in them. Canadian drug approvals for them have also grown exponentially.
- Most rare disease drugs are covered by government funding but given the growth in this category and their associated ultra-high price tags (some more than $1 million annually), government funding may no longer be reliable. Alberta Blue Cross® watches these drugs closely and subjects them to our drug review process prior to listing them on our drug plans.
- Biosimilars are drugs that are similar to the reference biologic drug already authorized for sale but are available at a reduced price. There has been an increase in the use of biosimilar drugs in recent years due to provincial biosimilar initiatives, leading to savings for patients and private drug plans.
- Health Canada-approved biosimilars for Humira, Enbrel and Remicade have been on the market for a few years. However, the biosimilar market continues to grow with additional biosimilar versions of these biologics arriving in the Canadian drug market, helping to further bring down drug costs.
- Generic drugs enter the market after patent and data protection of the brand name drug ends via expiry or litigation. First-entry generic drugs, which are generic products for brand name drugs that previously did not have generic options available, impact private drug plans most when they become available for commonly utilized or high-cost therapies.
- The 2 health conditions which have notable first-entry generics coming to the Canadian drug market are diabetes and ADHD. These health conditions have been growing year over year in utilization and spend, and were in the top 5 health conditions of Alberta Blue Cross® private plans in 2021.
Alberta Blue Cross® drug management strategy
Drug plan management at Alberta Blue Cross® has a solid unique foundation built on systems and management processes. We offer optional plan management features and financial strategies for our clients that help mitigate rising drug costs and ensure plan sustainability, all while making sure plan members have access to the care they need.
If you have any questions about this topic or others, please don’t hesitate to contact your Alberta Blue Cross® representative.