Author(s)
Canadian Health Policy Institute (CHPI)
Introduction
It is roughly estimated that as of 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. The quality of coverage varies significantly between public drug plans. Some jurisdictions provide much better benefits for their publicly insured populations than do other jurisdictions. This study ranks the quality of coverage for new drugs under federal and provincial public drug plans from best to worst.
Objective
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.
Data
The most recent data were obtained from Health Canada and IMS Brogan covering the period from January 1, 2004 to December 1, 2013.
Results
Averaged across all public plans and across all years observed, of the 412 new drugs approved for sale by Health Canada over the 9-year period from 2004-2012 only 23.1% were covered for full or partial public coverage 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.
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. Quebec and Ontario provide the highest coverage rates for new drugs, while Manitoba, Alberta, British Columbia and the federal NIHB provide the lowest coverage rates.
Quebec had the shortest delays to listing new drugs for reimbursement on its public drug plan, while New Brunswick, PEI and Ontario had the longest delays to listing.
New Brunswick and Quebec had the highest number of new drugs listed for full reimbursement, while Manitoba, British Columbia, the NIHB, Ontario and Saskatchewan had the lowest number of full reimbursements.
Conclusions
Overall, Quebec appears to provide the best access to new drugs under its public drug plan. 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 than do private sector drug insurance plans.
