Our annual Drug Pipeline white paper reports on the latest trends affecting your plan’s cost, coverage and sustainability. By monitoring the drug and health landscape, we can better predict what changes our plan members might see in the future and how we can prepare for those changes now.
Diabetes, weight loss, generics and biosimilars continue to impact private plans, according to our 2024 Drug Pipeline white paper.
While we expect claims and spending for some treatments to grow, we also see more affordable treatment options on the horizon. Our goal is to provide the best health and wellness support for our members, while ensuring the future sustainability of benefit plan offerings.
We looked at more than 300 drugs currently under review with Health Canada to find out how they might affect you. Here’s what’s coming down the (drug) pipeline.
Generics and biosimilars
Generic and biosimilar drugs provide more affordable treatment options for patients and cost savings for health plans. Some notable generic drugs and biosimilars in the pipeline include the following:
- Autoimmune disorders. The high-cost drug Stelara now has biosimilar options available in Canada. Stelara is a top 10 drug by spend for Alberta Blue Cross® as it treats various autoimmune disorders.
- Attention-Deficit Hyperactivity Disorder (ADHD). Adult-diagnosed ADHD is on the rise, and in 2023, ADHD was the second health condition by spend for Alberta Blue Cross®. Vyvanse is the top medication on our plans for ADHD. A first-entry generic for Vyvanse will lead to savings for plans that have generic pricing policies.
- Diabetes. First-entry generics are becoming available for many diabetes medications.
- Relapsing Remitting Multiple Sclerosis (RRMS). Health Canada is reviewing a generic drug for the specialty drug Mavenclad, which is an oral treatment for RRMS.
Diabetes and weight loss
Diabetes continues to be one of Canada’s most expensive health conditions. New treatments can help manage insulin-dependent diabetes. Health Canada recently approved the first once-a-week insulin dose, which will help people with diabetes follow more convenient treatment plans and have easier lives.
Drug manufacturers are also seeking approval to use diabetes medications to treat weight loss, as well as other health conditions that benefit from weight loss such as chronic heart failure and obstructive sleep apnea. We expect diabetic drugs that help with weight loss will continue to have a large impact on drug plans.
Migraines
About 12 per cent of the population, or 4.5 million Canadians, suffer from migraines. We expect claims and plan spending for migraine treatment to grow as new oral medications provide additional treatment options for members experiencing migraines.
Dermatology
Treatments for dermatological conditions are growing. In the past year, we saw 2 new biologics and 2 new topical medications introduced. Health Canada is currently reviewing another 2 new topical treatments, one for plaque psoriasis and the other for both vitiligo and atopic dermatitis. However, these treatments may come with a higher price tag compared to other topical treatments.
Neurology
Health Canada is currently reviewing Leqembi, a breakthrough treatment for Alzheimer’s disease. Also making their way to Canada are new targeted therapies that can treat generalized myasthenia gravis. While these drugs may improve symptoms for those living with generalized myasthenia gravis, they also have higher prices and place pressure on private drug plans.
COVID treatments
Treatments for COVID-19 infections have historically been publicly funded. However, we may see costs shifting to private payers as public funding comes to an end.
Rare disease drugs
Rare disease drugs continue to be both complex and expensive. To address this, the federal government announced its first-ever National Strategy for Drugs for Rare Diseases, which will invest up to $1.5 billion over 3 years to make rare disease drugs more accessible and affordable. Unfortunately, this funding most likely won’t be enough to provide universal coverage.
Alberta Blue Cross® drug management strategy
Drug plan management at Alberta Blue Cross® has a solid foundation built on systems and management processes. We offer our clients plan management features and financial strategies to help with the rising cost of drugs, all while ensuring our plans stay sustainable and our plan members have access to the care they need.
If you have any questions about this topic, please don’t hesitate to contact your Alberta Blue Cross® representative.
DON’T KNOW IF THIS IS THE RIGHT FORUM, BUT AM LOOKING FOR FOOT CARE BENEFITS, I UNDERSTAND FOOT CARE IS NO LONGER COVERD BY BLUE CROSS IS THIS RIGHT ?