Top 10 drugs in 2019

As part of the development and implementation of its drug management strategies, iA Financial Group is tracking certain key indicators. One of these indicators is the analysis of the highest amounts reimbursed for the top ten drugs for all group insurance contracts in a year.

In 2019, these ten drugs represented 20% of the amounts reimbursed but only 8% of the total number of claims processed by iA Financial Group.

Our top ten drugs can be divided into two categories:

• Specialty drugs: expensive, often biologic drugs, for relatively infrequent conditions
• Traditional drugs: affordable, generic drugs often available for common conditions

The table below shows the top ten drugs by amount reimbursed in 2019, in descending order, and their respective rank in 2018 and in 2017.

Specialty drugs

More expensive than traditional drugs, several specialty drugs rank at the top of the list.

For the past several years, Remicade (infliximab), approved for the treatment of seven inflammatory disorders, has been at the top of the list in this category. However, the availability and increasing use of less expensive biosimilars is putting pressure to lower the cost of this drug. It will be interesting to see if this price drop in the average cost of infliximab will be enough to have a major impact on the cost of drug plans overall.

The continued popularity of Humira can be explained in part by the fact that it is indicated for nine different inflammatory conditions. The introduction of a biosimilar, already approved by Health Canada, is eagerly awaited in the market.

Gilenya, meanwhile, is no longer on the list, having moved down from 9th to 12th place. This immunomodulating agent modifies the progression of multiple sclerosis and a generic version has recently become available.

Traditional drugs

Like last year, Concerta and Vyvanse, two drugs used to treat attention deficit disorder with or without hyperactivity (ADHD and ADD) are in 3rd and 5th place respectively. Their high ranking on the list is explained by their popularity in Quebec. The debate on the use of ADD and ADHD drugs in Quebec is still ongoing while many observers question the high utilization rate and the striking disparity that exists between Quebec and the other provinces.

Further down the list are Janumet (up two spots), blood glucose test strips (7th), Crestor (8th), and Cipralex (9th), which treat diabetes, high cholesterol and depression respectively. Note that the upcoming arrival of a generic of Janumet is expected to decrease the expenses for this drug.

Management strategies

These observations provide avenues for consideration to determine the best drug management approaches. Based on these elements and other key indicators, iA Financial Group is developing management strategies to propose to its clients. For example, in light of the top 10 results, we are working on strategies to increase the use of less expensive biosimilar products in order to better control drug costs.

Since these observations relate to the entire iA Financial Group set of claims, they are not necessarily adapted to all drug plans. We invite you to contact your advisor or your iA Financial Group Account Executive to discuss the features of your plan and to determine the best and most relevant strategies for you.