‘A growing backlog of new claimants in major therapeutic areas is expected to have long-term repercussions for benefits plans and disease management’
Potentially, more than 100,000 Canadians living with undiagnosed chronic diseases did not begin treatment in 2020.
This alarming trend is reflected in 2020's significant drop in new claimants for drugs used to treat chronic diseases such as diabetes and cancer, according to a report from Express Scripts, a pharmacy benefit management organization.
"This trend is a cause for concern," says Dorian Lo, president of Express Scripts Canada. "Delays in diagnosis and treatment increase the challenge for patients to manage their disease. For most conditions, seeking care in the earlier stages likely improves health outcomes and helps decrease the risk of disease progression and related consequences."
From the end of March to December 2020, there was a two per cent average decline of weekly new claimants for cancer medications. This could lead to an estimated backlog of more than 10,000 Canadians who potentially have not started treatment for cancer.
For the same time period, there was also a one per cent average decline in weekly new claimants for diabetes medications. The impact? An estimated backlog of more than 20,000 Canadians who potentially have not started treatment for the disease.
"Delays in cancer screening and the interruptions to surgeries may result in a shift towards treating more advanced cancers, with fewer therapeutic options at a higher cost," says Jeff Boutilier, general manager for pharmacy and chief clinical officer at Express Scripts Canada. “Delayed treatment of diabetes is associated with a higher risk for therapy intensification.”
Individuals who became sick or developed new symptoms last year may have delayed a visit to a health professional due to accessibility issues (closed or reduced services) or fear of exposure to the coronavirus.
This follows a recent report from HealthPartners, which found that 66 per cent of Canadians living with a chronic illness or major illness have faced challenges accessing treatment and care.
This could be a problem for benefits providers, according to Express Scripts. Cumulative backlog of claimants with delayed treatment of conditions may result in increased health-related issues such as the risk of a heart attack or stroke. And this could lead to more claims for medication and potentially a need for therapies.
"Those people who didn't seek medical attention for potential chronic diseases in 2020 could seek a diagnosis in 2021 or beyond," says Boutilier. "Benefits plans could be affected by greater numbers of claimants in the future. A growing backlog of new claimants in major therapeutic areas is expected to have long-term repercussions for benefits plans and disease management."
Also, employer-provided medical benefit costs in Canada are expected to rise by seven per cent this year, up from six per cent for 2020, according to a report from Aon.
Wait times challenges
In a December 2020 report, the Fraser Institute noted that the total waiting time for elective, medically necessary, treatment across Canada was 22.6 weeks, up from 20.9 weeks in 2019. But this differs from province to province.
Wait times are far longer in Prince Edward Island (46.5 weeks), Nova Scotia (43.5 weeks) and New Brunswick (41.3 weeks) compared to Saskatchewan (21.7 weeks), Quebec (18.8 weeks) and Ontario (17.4 weeks).
“Despite provincial strategies to reduce wait times and high levels of expenditure on health care, it is clear that patients in Canada are waiting too long to receive treatment,” said Bacchus Barua, associate director of the Fraser Institute’s Centre for Health Policy Studies, and Mackenzie Moir, junior policy analyst at the Fraser Institute.
The Canadian economy lost almost $2.1 billion in lost productivity and wages in 2019 due to long wait times for surgery and other medical treatments, according to a Fraser Institute study.