TELUS Health Report 2023

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P. 5 There has also been a shift in eligible amounts by age group, with younger adults moving ahead of those in older demographics. When analyzing claims data by age, we find that the growth rate in eligible amount for plan members under the age of 25, at 14.2%, is more than double that of plan members aged 60 to 64 (6.2%) and 50 to 59 (5.4%). The report also outlines the growing impact of biosimilar switching policies on cost trends in 2022, and found that savings are mostly being offset by growth in the use of higher-cost, second- and third-line therapies for chronic diseases such as diabetes. The result is moderate growth in spending by private drug plans for the third year in a row, with a slight decline in 2022. B.C. was the first province to launch a switching policy (in 2019), and saw biosimilars' share of claims to private plans in the biologics category climb from 5.5% at the start of 2019 to 20.4% by end of that year. As of December 2022, biosimilars accounted for 64.7% of claims for all biologics. Similarly dramatic results occurred in Quebec, where the share grew to 38% by the end of April 2022. By the end of 2022, in lockstep with B.C., their share reached 64.8%. These policies have had a ripple effect on private drug plans, particularly in B.C. and Quebec, where sponsors have followed the lead of public payors in biosimilar switching. Nationally, that has translated to significant growth of biosimilars' share of claims in the biologics category from just 4.2% in January 2019 to 32% in December 2022. That will likely accelerate in 2023 and 2024, as remaining provinces and territories complete their transition periods. The impact of biosimilar switching was only one factor in the shifting proportion of plan costs in 2022. For the first time in more than 10 years, the growth rate for specialty drugs fell behind that of traditional. While the number of claimants increased for specialty drugs—with the largest single-year increase since TELUS Health's reporting began—the share of eligible amounts declined for the first time since 2008 compared to traditional drugs. In contrast, the utilization and related costs of traditional drugs have also surged in 2022, with use rebounding since the start of the pandemic.

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