Rare disease treatments and new antidiabetics push public drug costs higher, PMPRB report finds
Prescription drugs costing over $10,000 annually now account for more than one third of total public drug plan costs in Canada, despite being used by only 3 percent of beneficiaries, according to the latest CompassRx report from the Patented Medicine Prices Review Board (PMPRB).
The report highlights that the ten highest-cost drugs—each a rare disease treatment—carry annual treatment costs exceeding $300,000.
As reported by the PMPRB, overall prescription drug expenditure for public drug plans rose by 7.4 percent in 2022/23, reaching $14.1bn, up from $13.2bn the previous year.
This surge was primarily driven by increased use of higher-cost medicines and a post-pandemic rebound in active beneficiaries.
Drug costs, which represent 83 percent of prescription drug expenditures, grew by 7.9 percent over the same period.
The CompassRx report identifies elexacaftor/tezacaftor/ivacaftor (Trikafta), a cystic fibrosis treatment, as the top contributor to rising drug costs.
Trikafta ranked first in expenditure after just two years on the market, propelled by its high price and rapidly growing usage.
Additionally, three antidiabetic medications—semaglutide (Ozempic), empagliflozin (Jardiance), and dapagliflozin (Forxiga)—collectively contributed to the growth in drug costs.
According to the PMPRB, medicines costing over $25,000 annually were used by less than 1 percent of beneficiaries but accounted for over 20 percent of drug costs.
Of 6.6 million active beneficiaries, the 7.6 percent with annual drug costs exceeding $5,000 represented 62.3 percent of total public plan drug costs.
The PMPRB’s CompassRx report, which covers all provincial public drug plans except Quebec, as well as Yukon, provides critical insight into the factors driving prescription drug expenditures.
The findings are intended to inform policy discussions and help decision makers anticipate and respond to evolving cost pressures in public drug plans.
Through the National Prescription Drug Utilization Information System (NPDUIS), the PMPRB also supplies stakeholders with timely data to support informed drug pricing, purchasing, and reimbursement decisions.
