Transcript Prescribed Drug Spending in Canada, 2013: A Focus on

Prescribed Drug Spending in Canada, 2013:
A Focus on Public Drug Programs
Chartbook
May 2015
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Please cite as follows:
Canadian Institute for Health Information. Prescribed Drug Spending
in Canada, 2013: A Focus on Public Drug Programs. Ottawa, ON:
CIHI; 2015.
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About CIHI’s NPDUIS Database and NHEX Data
CIHI’s National Prescription Drug Utilization
Information System (NPDUIS) Database
provides data on key aspects of public drug
plans in Canada. These include claims and
formulary data, drug product information and
plan information.
CIHI’s National Health Expenditure Database
(NHEX) has been collecting, processing
and analyzing summary data on all health
spending in Canada since 1975. Health
expenditures for the most recent 2 years
are also forecasted.
Information from the NPDUIS Database is used
to support accurate, timely and comparative
analytical and reporting requirements for the
establishment of sound pharmaceutical policies
and the effective management of Canada’s
public drug benefit programs.
Information from NHEX is used to facilitate
provincial/territorial, national and international
comparative reporting. NHEX information also
supports policy planning, decision-making
and research.
For more information, please contact
Program Lead, National Prescription Drug Utilization Information System Database
Canadian Institute for Health Information
495 Richmond Road, Suite 600
Ottawa, Ontario K2A 4H6
Phone: 613-241-7860
Fax: 613-241-8120
Email: [email protected]
Website: www.cihi.ca
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In 2014, Canadians spent an estimated $28.8 billion
on prescribed drugs
Total Health Expenditure, by Use of Funds, Canada, 2014f
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Growth in prescribed drug spending has slowed
in both the public and private sectors since 2000
Prescribed Drug Spending, Canada, 2000 to 2014f
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Recent years have seen slow growth in major health
categories of public-sector health spending
Annual Growth Rate of Publicly funded Health Spending, by Selected
Categories, 2000 to 2014f
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In 2014, 42.0% of prescribed drug spending was
financed by the public sector
Publicly Funded Drug Spending as a Percentage of Prescribed Drug
Spending, by Source of Finance, by Province and Canada, 2014f
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The top 10 drug classes accounted for 32.9%
of public drug program spending
Top 10 Drug Classes by Public Drug Program Spending,
Selected Jurisdiction,* 2013
TPS
($ Millions)
Proportion
of TPS (%)
Drug Class
Common Uses
Tumour Necrosis Factor Alpha Inhibitors
(Anti-TNF Drugs)
Rheumatoid Arthritis, Crohn’s Disease
576.7
7.4
Antineovascularization Agents†
Age-Related Macular Degeneration
337.3
4.3
HMG-CoA Reductase Inhibitors (Statins)
High Cholesterol
295.6
3.8
Proton Pump Inhibitors (PPIs)
Gastroesophageal Reflux Disease, Peptic
Ulcer Disease
249.6
3.2
Adrenergics in Combination With
Corticosteroids or Other Drugs,
Excluding Anticholinergics
Asthma, Emphysema,
Chronic Bronchitis
217.3
2.8
Angiotensin-Converting Enzyme (ACE)
Inhibitors, Plain
Heart Failure, High Blood Pressure
190.7
2.5
Selective Serotonin Reuptake Inhibitors
Depression
185.8
2.4
Natural Opium Alkaloids
Management of Moderate to Severe Pain
180.5
2.3
Other Antidepressants
Depression
171.5
2.2
Diazepines, Oxazepines, Thiazepines
and Oxepines
Schizophrenia, Bipolar Disorder
155.9
2.0
2,560.9
32.9
Combined Top 10
© Canadian Institute for Health Information, 2015
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Generic drugs accounted for the majority of use
but just more than one-third of spending
Percentage Share of Public Drug Program Spending and Number of
Accepted Claims (Brand Name and Generic), Selected Jurisdictions,* 2013
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Decreased spending in some drug classes was
largely offset by significant increases in others
Average Annual Growth in Public Drug Program Spending for
Top 10 Drug Classes by TPS, Selected Jurisdictions,* 2003 to 2013
Drug Class
Common Use
Tumour Necrosis Factor Alpha Inhibitors
(Anti-TNF Drugs)
Rheumatoid Arthritis,
Crohn’s Disease
Antineovascularization Agents†
Age-Related Macular Degeneration
HMG-CoA Reductase Inhibitors (Statins)
High Cholesterol
Proton Pump Inhibitors (PPIs)
Gastroesophageal Reflux Disease,
Peptic Ulcer Disease
Adrenergics in Combination With
Corticosteroids or Other Drugs,
Excluding Anticholinergics
AAG in TPS, AAG in TPS,
2003 to 2008 2008 to 2013
(%)
(%)
Percentage
Change Over
2012
(%)
39.0
24.8
18.3
0.2
148.4
25.8
13.1
-17.3
-38.3
3.7
-7.4
-25.4
Asthma, Emphysema,
Chronic Bronchitis
17.4
8.7
6.1
Angiotensin-Converting Enzyme (ACE)
Inhibitors, Plain
Heart Failure, High Blood Pressure
-1.7
-7.6
-19.4
Selective Serotonin Reuptake Inhibitors
Depression
-1.7
-1.2
-13.8
Natural Opium Alkaloids
Management of Moderate to
Severe Pain
13.3
3.4
0.7
Other Antidepressants
Depression
5.6
1.9
-10.2
Diazepines, Oxazepines, Thiazepines
and Oxepines
Schizophrenia, Bipolar Disorder
7.1
-7.9
-13.7
7.9
1.7
-2.4
All Drug Classes
© Canadian Institute for Health Information, 2015
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4 of 10 drug classes that contributed most to the
growth of public drug spending are biologic agents
Top 10 Drug Classes by Contribution to Public Drug Program Spending
Growth, Average Annual Growth, Selected Jurisdictions,* 2008 to 2013
Drug Class
Common Use
Tumour Necrosis Factor Alpha
Inhibitors (Anti-TNF Drugs)
Rheumatoid Arthritis, Crohn’s Disease
Antineovascularization Agents‡
Contribution to
Average
TPS Growth Annual Growth
(%)
(%)
Percentage
Change
Over 2012
(%)
126.3†
24.5
17.8
Age-Related Macular Degeneration
33.3
148.5
25.7
Insulins and Analogues for Injection,
Long-Acting
Diabetes Mellitus
13.9
55.0
42.9
Adrenergics in Combination With
Corticosteroids or Other Drugs,
Excluding Anticholinergics
Asthma, Emphysema, Chronic Bronchitis
13.3
8.5
5.2
Other Antipsychotics
Schizophrenia, Bipolar Disorder
12.7
15.3
15.5
Protease Inhibitors
Human Immunodeficiency Virus (HIV)
11.3
48.5
93.7
Drugs Used in Opioid Dependence
Drug Addiction, Pain Control
9.5
12.5
6.5
Selective Immunosuppressants
Organ Transplant
9.0
21.2
20.1
Interleukin Inhibitors
Rheumatoid Arthritis, Psoriasis,
Organ Transplant
8.1
106.8
63.1
Anticholinergics
Emphysema, Chronic Bronchitis
6.8
8.6
6.2
100.0
1.5
-2.1
All Drug Classes
© Canadian Institute for Health Information, 2015
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The majority of public drug spending was for a
relatively small number of high-cost individuals
Percentage of Paid Beneficiaries and Public Drug Program Spending,
by Program Spending per Paid Beneficiary, 2013, Selected Jurisdictions*
Program Spending
Proportion of
Paid Beneficiaries (%)
Proportion of TPS (%)
<$500
56.1
6.3
$500–$1,499
22.8
16.7
$1,500–$2,499
8.9
14.0
$2,500–$4,999
7.7
21.6
$5,000–$9,999
2.8
15.0
$10,000+
1.6
26.3
© Canadian Institute for Health Information, 2015
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The share of public drug spending on high-cost
chemicals more than doubled between 2008 and 2013
Proportion of Public Drug Program Spending and Proportion of Chemicals
Paid, Chemical That Cost $10,000 or More per Paid Beneficiary, Selected
Jurisdictions,* 2008 to 2013
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