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What’s Trending in Health and Drugs Benefits?

Top Takeaways from Our 2024 Claims Data Analysis

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We took a deep dive into our 2024 claims data to uncover emerging trends in health and drug benefits. We converted our data analytics into actionable insights and shared them at our first Insights webinar of 2025 to help employers navigate the constantly evolving benefits landscape. Our analysis revealed six key themes shaping plans, costs, and access to care: specialty drugs, diabetes, weight management, ADHD, mental health, and menopause.

Diabetes

Diabetes drug utilization has increased slightly, but overall spending on diabetes medications has decreased due to our automated criteria for GLP-1 drugs (e.g., Ozempic).

  • Diabetes remained the second largest drug category, representing 7% of drug claims and making up 13% of overall drug spend.

  • 41% of our members claimed for at least one chronic condition like diabetes, up from 37% in 2019.

  • Of those claiming, 55% are claiming for 1 chronic condition, 28% for 2, and 17% for 3 or more chronic conditions.


Diabetes

Diabetes drug utilization has increased slightly, but overall spending on diabetes medications has decreased due to our automated criteria for GLP-1 drugs (e.g., Ozempic).

  • Diabetes remained the second largest drug category, representing 7% of drug claims and making up 13% of overall drug spend.

  • 41% of our members claimed for at least one chronic condition like diabetes, up from 37% in 2019.

  • Of those claiming, 55% are claiming for 1 chronic condition, 28% for 2, and 17% for 3 or more chronic conditions.


Weight management

Weight management drugs were the #3 trend driver in 2024, with a 150% increase in claimants per 100 from 2023. These drugs are supporting a reduction in comorbid conditions, including sleep apnea, diabetes, and respiratory conditions. ​

  • Since entering the market in May 2024, Wegovy has become the #1 weight management drug claimed by members, representing 62% of the spend.

  • However, the incidence is still low. Weight management represents less than 1% of member claims and accounts for 1% of overall drug spend.

  • 79% of weight management drug claimants are female.

Specialty drugs

The pharmaceutical landscape is being disrupted by the expansion of specialty drugs to treat many common conditions. Additionally, there is growth in newer therapies that don’t have a generic or biosimilar.​

  • Specialty drugs account for just 1% of drug claims but represent 36% of total drug plan spend.

  • 78% of our Medication Advisory Panel reviews in 2024 were for specialty drugs (drugs costing $10,000+), and only 22% were for traditional drugs.

  • Inflammatory conditions (e.g., asthma, rheumatoid arthritis) continue to be a major driver of specialty drug trends ― and growing. The overall trend sits at 10.8%, most of which is driven by increases in utilization.

  • Drugs to treat cancer are the second most common and account for one-third of the new drug pipeline.

  • This trend is being driven by several key factors: a higher incidence of cancer diagnoses, increased use of combination therapies 2 or more drugs to treat cancer, and the rising cost of new therapies, putting increased financial pressure on benefit plans.

  • The average age of cancer claimants fell from 49 in 2020 to 47 in 2024.

  • Drugs to treat multiple sclerosis (MS) are now the third most prevalent in our specialty claims data. Unlike other trends driven by increased utilization, this one is largely fueled by inflation.

Specialty drugs

The pharmaceutical landscape is being disrupted by the expansion of specialty drugs to treat many common conditions. Additionally, there is growth in newer therapies that don’t have a generic or biosimilar.​

  • Specialty drugs account for just 1% of drug claims but represent 36% of total drug plan spend.

  • 78% of our Medication Advisory Panel reviews in 2024 were for specialty drugs (drugs costing $10,000+), and only 22% were for traditional drugs.

  • Inflammatory conditions (e.g., asthma, rheumatoid arthritis) continue to be a major driver of specialty drug trends ― and growing. The overall trend sits at 10.8%, most of which is driven by increases in utilization.

  • Drugs to treat cancer are the second most common and account for one-third of the new drug pipeline.

  • This trend is being driven by several key factors: a higher incidence of cancer diagnoses, increased use of combination therapies 2 or more drugs to treat cancer, and the rising cost of new therapies, putting increased financial pressure on benefit plans.

  • The average age of cancer claimants fell from 49 in 2020 to 47 in 2024.

  • Drugs to treat multiple sclerosis (MS) are now the third most prevalent in our specialty claims data. Unlike other trends driven by increased utilization, this one is largely fueled by inflation.

ADHD

Attention Deficit Hyperactivity Disorder (ADHD) is a common, complex, but manageable neurodevelopmental condition. With increasing awareness of ADHD and its challenges, there has been a notable rise in diagnoses, particularly since the start of the pandemic.

Growth

ADHD medication use continues to grow, particularly among adults, with females now making up more than 50% of claimants.

Diagnoses

We’re seeing a significant increase in both ADHD diagnoses and treatment rates, particularly among adults aged 30+.

Claims

ADHD represented 4% of drug claims and 5% of overall drug spend in 2024.

Mental health

We’ve seen sustained growth of over 20% per year in claims spend for mental health practitioners for the past three years. For the first time, the spend for practitioners surpassed drugs for mental health, accounting for almost 14% of our total EHC spend, second only to massage therapy at nearly 18%.

  • Mental health practitioners were the biggest trend driver among the top 10 EHC categories, contributing 2.5% growth to the overall EHC trend.

  • Mental health represented 13% of member claims and 9% of overall health spending.

  • Mental health also remained the #1 cause of disability leave across all age groups.

  • 12% of our members who claimed a mental health benefit in 2024 accessed both drugs and counselling – up from 10% in 2022.

  • Mental health drugs made up 6.3% of the total drug spend in 2024.

  • Mental health practitioners were the fourth most claimed benefit for females and the fifth most claimed benefit for males in 2024, compared to the ninth the previous year (based on percentage of total spend for drugs and extended health benefits combined).

Mental health

We’ve seen sustained growth of over 20% per year in claims spend for mental health practitioners for the past three years. For the first time, the spend for practitioners surpassed drugs for mental health, accounting for almost 14% of our total EHC spend, second only to massage therapy at nearly 18%.

  • Mental health practitioners were the biggest trend driver among the top 10 EHC categories, contributing 2.5% growth to the overall EHC trend.

  • Mental health represented 13% of member claims and 9% of overall health spending.

  • Mental health also remained the #1 cause of disability leave across all age groups.

  • 12% of our members who claimed a mental health benefit in 2024 accessed both drugs and counselling – up from 10% in 2022.

  • Mental health drugs made up 6.3% of the total drug spend in 2024.

  • Mental health practitioners were the fourth most claimed benefit for females and the fifth most claimed benefit for males in 2024, compared to the ninth the previous year (based on percentage of total spend for drugs and extended health benefits combined).

Menopause

As highlighted in our June 2024 webinar on this topic, there’s a growing demand for benefits and education to support women during midlife, as more attention is being paid to how menopause affects the health and productivity of working women. Women make up nearly 50% of Canada’s workforce and of our plan member base.

  • Hormone therapy, a treatment option for relief of menopausal systems, is now a top 10 drug trend driver. This trend is not due to cost as hormone therapy is relatively inexpensive, but because more women are seeking to adjust to midlife and hormonal changes.

Solutions Spotlight

Medavie Blue Cross continuously analyzes its data to identify changes in claiming patterns and to develop innovative solutions that not only keep pace with—but stay ahead of—emerging health and drug benefit trends. Below are just a few of the solutions we offer to help employers improve member well-being and optimize their benefit plans.

Diabetes, Blood Pressure, and Obesity Coaching Program

Offers personalized health coaching from a team of healthcare professionals and linked to an app for remote monitoring of chronic conditions.

Learn more
Weight Management Benefit

Provides access to weight management medications – like Wegovy. As our own pharmacy benefit manager (PBM) we can support flexibility with plan design and maximums.

ADHD Assessment and Treatment

Provides accessible and affordable services to assess, diagnose and treat ADHD

Learn more
Mental Wellness Benefits

Provides direct access to expert support or self-service resources for managing mental health.

Learn more
Menopause Assessment and Coaching

An industry-first, personalized care program that offers support for every stage of the menopause journey

Learn more

Have Questions?

Reach out to your Medavie Blue Cross account executive for personalized insights and solutions to help you make the best benefit decisions and achieve your goals. Whether you're looking to optimize your current benefits plan or explore new options, your account executive is there to support you every step of the way.

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