Author
Canadian Health Policy Institute (CHPI).
Introduction
In 2012, 11.3 million Canadians were eligible for coverage under public drug insurance programs, including 10.3 million provincial-territorial residents and nearly 1 million federally insured aboriginal people. Over 23 million Canadians have private drug insurance coverage. An additional 700,000 Canadians have no insurance to pay for drugs.
Objective
To compare benefits under Canada’s public drug programs in terms of the number of new drugs approved for public insurance, as well as the time that patients must wait for insured access to new medicines. To compare public drug programs against benchmarks set by private-sector drug insurance in Canada.
Data
Health Canada data is used to identify New Drug Submissions [NDSs] certified as safe and effective from 2004 to 2011, and IMS Brogan’s iMAM database is used to measure drug insurance approval rates and insurance approval delays.
Results
Averaged across all public plans, as of December 1, 2012, only 20.5% of the new drugs approved by Health Canada from 2004-2011 were insured and patients waited 659 days for insured access. Between jurisdictions, QC had the most generous public insurance coverage for new drugs (38.9%) and MB had the least generous (12.6%). The wait for publicly insured access was shortest in QC (430 days) and longest in PEI (908 days). In a private-public comparison across the country, 81% of new drugs were insured by at least one private plan compared to 47% by at least one public plan, and patients covered under private plans waited 127 days for insured access, compared to 467 days for patients covered under public plans.
Conclusion
People insured under public drug plans have relatively limited access to new medicines and access varies by jurisdiction. People insured under private-sector drug plans have better access to new medicines.
