Last year, Canada spent C$29.3 billion on prescription drugs but, at 2.3%, the rate of rise in spending was the second-lowest for more than 20 years, say new figures.

Prescription drugs represent the third-largest category of health spending in Canada, and in 2013 they accounted for 85% of the total national medicines bill, which stood at C$34.5 billion, according to the latest figures from the Canadian Institute for Health Information (CIHI).

The slower growth in spending last year was due to increased use of generics and related pricing policies, says the study, which notes that generics account for almost three-quarters of Canada’s total drug use but only 38.8% of spending by public drug programmes, which account for an estimated 41.6% of prescribed drug spending.

The remainder was financed by private insurers (34.5%) and out-of-pocket by households and individuals (23.9%).

Spending on drugs by Canada’s public-sector programmes is also forecast to have grown at a negligible rate last year, less than 0.1%, which is the lowest rate of rise since 1996.

In 2012, the top 10 drug classes accounted for 34.2% of spending by Canada’s public drug programmes, with tumour necrosis factor alpha inhibitors (anti-TNF drugs) representing the highest proportion of the programmes’ spending during that year, followed by statins and proton pump inhibitors (PPIs).

60.8% of the programmes’ spending was accounted for by just 12.7% of individuals, for whom the schemes paid C$2,500 or more toward their annual drug costs, while 6.2% of spending was for 52.1% of individuals, for whom the programmes paid less than C$500 towards their annual drug costs.

The study also finds that the number of Canadians who are taking more than C$10,000-worth of prescription drugs each year is on the rise; in 2012, such high-cost beneficiaries accounted for about 25% of public drug spending, compared with only 15% in 2007.

Almost half these people were taking a high-cost drug to treat conditions such as rheutmatoid arthritis, Crohn’s disease and macular degeneration in 2012, it adds.