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Top 10 drugs in 2020

News Release

As part of the development and implementation of drug utilization management strategies, iA Financial Group tracks certain key indicators. One of them is the ranking of the ten drugs that account for the highest spending for all group insurance contracts in a year.

In 2020, these ten drugs represented 20% of the amounts reimbursed, but only 8.5% of the total number of claims processed by iA Financial Group. In 2019, they represented 20% of the amounts reimbursed and 8.1% of the number of claims.

Impact of COVID-19
While the pandemic had a significant impact on claims in 2020, it did not have a direct effect on the drugs in the top 10. We observed a significant increase in claims for antidepressants and a significant decrease in claims for the anti-infective category, such as antibiotics. These observations illustrate the impact of COVID-19 on mental health as well as the positive effects of health measures on the spread of infectious diseases other than COVID-19.

Top 10 drugs in a nutshell
The top 10 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 10 drugs by amounts reimbursed in 2020, in descending order, and their respective rank in 2019 and in 2018.

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

For the first time, REMICADE, approved for the treatment of seven inflammatory disorders, was displaced from the top spot. The availability and increasing use of less expensive biosimilar drugs, exerting downward pressure on cost, explains its decline.

HUMIRA, another biologic drug in the same category as REMICADE, is now number one. With the patent expiry of HUMIRA, Health Canada has recently authorized the introduction of six biosimilar products. Competition for market share will be fierce for this product, which is considered one of the most important “blockbusters” in pharmaceutical history.

Traditional drugs
As in 2019, CONCERTA is ranked 3rd and VYVANSE is ranked 6th. These two drugs are used to treat attention deficit disorder with or without hyperactivity (ADHD and ADD). Their high ranking is explained by their high use in Quebec, a significant disparity with other Canadian provinces.

Next in line are OZEMPIC, which comes in at number 7 this year, and JANUMET (8th) for the treatment of diabetes. Then we have CIPRALEX (9th) and CRESTOR (10th) for the treatment of depression and hypercholesterolemia respectively. The placement of these two drugs in the top 10 is not due to high treatment costs, since generic drugs are available, but to the high prevalence of these conditions. In the 5th spot, a newcomer this year is FREESTYLE LIBRE, which has been very popular since its launch. FREESTYLE LIBRE is a glucose monitoring system that has largely replaced traditional blood glucose test strips, which ranked 7th last year. When you add up the spending on FREESTYLE LIBRE and traditional strips, these diabetic supplies move up to 3rd in reimbursement amounts. This category will be closely monitored.

Management strategies
Based on these observations, and other key indicators, iA Financial Group is developing effective management strategies for its clients. For example, in light of the top 10 results, we are actively working on strategies to increase the use of biosimilar products to better control the costs of targeted biologic drugs. We are also looking at various strategies related to glucose monitoring systems to encourage judicious use and control cost growth.

Since these observations cover all claims processed by iA Financial Group, they are not necessarily adapted to the particularities of each drug plan we administer. 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.

Frédéric Leblanc, pharmacist
Strategic Advisor, Drug Programs Management