18 P.
Developments in the diabetes category will have the biggest impact on private plans this year and in the near future, for
two opposite reasons: on the one hand, new higher-cost second-line therapies continue to arrive on the market; on the
other hand, dozens of generic versions of the oldest of these second-line therapies will become available, starting this year.
While generic drugs are good news for drug plans, the extent of savings generated by generic second-line diabetes
therapies may be limited at first since they are for the oldest, less-utilized medications. It will be several years yet before
the expected patent expiry of the most prescribed second-line diabetes therapy, Ozempic. Meanwhile, product life cycle
management for Ozempic is well underway, as a new version of the drug—with even better weight-loss outcomes—is
expected to launch before the current patent expires.
The weight-loss benefits of the second-line diabetes therapies, which have led to off-label prescribing of these drugs,
help drive the category's growing share of total eligible amounts covered by private drug plans. Diabetes ranked second
on TELUS Health's top-10 list of categories by eligible amount in 2022, and it is poised to take over the number-one spot.
The two new drugs for migraine are worth watching. As the first two oral options in a new class of migraine drugs, their
overall utilization may grow among patients who have avoided the original injectable drugs. Indicated for those who are
hardest hit by migraines, these drugs could lead to increased productivity and fewer sick days in the workplace.
In the biologic space, biosimilar options slowly but steadily grow in number. For drug plan insurers with biosimilar switching
policies in place, the savings could be significant. This year will see the first biosimilar for macular degeneration. As well,
at least one biosimilar for Soliris, which made headlines in 2007 as the world's most expensive drug, will become available.
References
1. Norris, S. 100 Years of Insulin - Diabetes in Canada. Library of Parliament. Research Publication No. 2021-29-E. 2021 Dec.
2. Nandiwada S, Manca DP, Yeung RO, et al. Achievement of treatment targets among patients with type 2 diabetes in 2015 and 2020 in Canadian primary care.
CMAJ. 2023 Jan 9;195:E1-9. doi: 10.1503/cmaj.220673
3. Ramage-Morin PL, Gilmour H. Prevalence of migraine in the Canadian household population. Statistics Canada. Health Reports. 2014 Jun; Catalogue no. 82-003-X.
4. Moniz L, Andrews C, Pereira J. Canadian patient experience with age-related macular degeneration. IOVS. 2022 June;63(7):4226-A0154.
