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Where are the best and worst public drug plans in Canada for patient access to new medicines?

Posted on June 30, 2015

Where are the best and worst public drug plans in Canada for patient access to new medicines?

How good is your public drug plan? The answer to that question depends on where you live...

The 2014 edition of an annual study published by Canadian Health Policy Institute (CHPI) found that from 2004 to 2012, 412 new drugs were approved for sale by Health Canada, of which on average only 23.1% were fully or partially insured by public drug plans as of December 1, 2013. Of the new drugs that were eventually covered, it took on average 733 days for public drug plans to list a new drug on their formularies.

It is estimated that as of 2012, 11.3 million Canadians were eligible for coverage under public drug plans. By rationing access to new medicines, governments are limiting treatment options for millions of patients. Governments do this to reduce health spending, but the alleged savings from rationing access are a false economy. 

Coverage of available new drugs.

The quality of insured access to new drugs varies significantly between public drug plans. Some jurisdictions provide much better access for their publicly insured populations than do other jurisdictions.

CHPI ranked the quality of coverage for new drugs under federal and provincial public drug plans from best to worst. The goal was to compare benefits under Canada’s public drug programs in terms of the number of new drugs approved for public insurance coverage, as well as the time that patients must wait for publicly insured access to new drugs, as well as how restrictive the coverage was of patient choice. 

Quebec and Ontario provided the highest coverage rates for new drugs, while Manitoba, Alberta, British Columbia and the federal NIHB provide the lowest coverage rates.

However, it is important to put the performance of all public drug plans in the context of benchmarks set by private sector insurance plans. Other CHPI research confirms that all public drug plans in Canada provide much lower quality of coverage for new drugs when compared to private sector drug insurance plans. 

For more facts about the best/worst public drug plans for access to new medicines, download, Comparing access to new drugs in Canada's public drug plans. 2014 Annual Report, available at Canadian Health Policy

Find out more about the rates, waits and scope of coverage for new drugs in the public drug plan where you live. Learn who has the best public drug plan in Canada. The results might surprise you.

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