OBJECTIVES: The COVID-19 pandemic and the public health initiatives to contain it produced multiple shifts in insurance plan enrollment and drug claims. This study aims to draw attention to the sharp decline in claimants observed in Canada in 2020 and to ask whether the decline could impact patterns of drug claims and spending for years to come.

METHODS: We analyze 2015-2020 annual data from public drug plans affiliated with the National Prescription Drug Utilization Information System initiative, which includes approximately 7 million publicly insured active beneficiaries, and the IQVIA Private Drug Plan database, which accounts for about 70% of the Canadian private insurance market. Using this information, we investigate the changes in the number of active claimants in 2020 relative to 2015-2019 by jurisdiction, public sub-program, age group, and plan spending level, and we document the therapeutic classes which saw significant changes in the number of claims filed.

RESULTS: During the first year of the COVID-19 pandemic, we find declines of 6.7% and 1.9% in the respective number of private and public insurance plan claimants. These declines stand in contrast with the stable annual growth rates of approximately 3% observed between 2015 and 2019. In both private and public plans, the declines were restricted to the under-65 age groups (persons aged 0-24 and 25-64 years) and the lowest plan spending level group (<$5,000/year). Some of the therapeutic classes that saw the largest declines in claims, such as ophtalmologicals, suggest delayed treatment for affected claimants.

CONCLUSIONS: The onset of COVID-19 was associated with an extraordinary decline in claimants in Canada. This decline primarily impacted claimant groups below retirement age and with lower plan spending levels. The decline suggests the potential for a mild future rebound in claims.