(124) The Missing Claimants of the Pandemic: Who Went Without Claims in Canada During the First Two Years of the COVID-19 Pandemic and what Does it Mean for Public and Private drug plans?
Senior Economist Patented Medicine Prices Review Board (Government of Canada) Ottawa, Canada
Background: The COVID-19 pandemic and the public health initiatives to contain it produced important shifts in enrollment and claims for both public and private drug plans.
Objectives: This study aims to draw attention to the sharp swings in the number of claimants observed in Canada in 2020 and 2021 and to ask whether they could impact patterns of drug claims in the longer term.
Methods: We analyze 2015-2021 annual data from public drug plans affiliated with the National Prescription Drug Utilization Information System initiative, which includes approximately 7 million publicly funded active beneficiaries, and the IQVIA Private Drug Plan database, which accounts for over 70% of the Canadian private insurance market. We investigate changes in the number of active claimants in 2020 and 2021 relative to 2015-2019 by public/private plans, age group, gender, and plan spending level.
Results: After an unprecedented decline of nearly 1M total claimants during the first year of the COVID-19 pandemic, a rebound was observed in 2021 but claimants remained 910,000 below pre-pandemic trends. Private and public drug plans diverged in the magnitude of their rebound, with privately and publicly insured claimants 795,000 and 115,000 below the levels expected based on historical trends, respectively. In both public and private plans, the 2021 rebound was strongest among individuals with high annual drug spending levels ($5,000 or more), while claimants aged less than 25 remained well below pre-pandemic trends. The presentation will further detail these dynamics and discuss the therapeutic classes which saw significant declines in claims.
Conclusions: The COVID-19 pandemic produced important and lasting shifts in claiming for public and private drug plans. The number of claimants in both types of plans remained well below historical trends in 2021, possibly foreshadowing further rebound in the coming years.
