Abstract
Available evidence indicates that patients who have private sector drug insurance are immediately covered for all new medically necessary drugs certified by Health Canada, with few exceptions. The experience for patients who are dependent on public drug programmes is much worse. Evidence indicates that, on average across the provinces, far less than half of the drugs certified by Health Canada are finally approved by the provinces for public reimbursement. Publicly insured patients also wait up to 1 year longer than privately insured patients to get insurance coverage for new drugs. Evidence also shows that public drug coverage varies widely across provinces.
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Notes
Some private plans exclude ‘non-medically necessary’‘life-style’ drugs.
‘Pharmaceutical’ drugs are chemical-based products; ‘biological’ drugs are biochemical-based products.
There are three classes of non-generic new drug approval submissions: new active substances, new drug submissions and supplemental new drug submissions.
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The author declares no conflict of interest regarding the influence of either government or private sector sources of funding. The author freely discloses that his employer is a Canada-based, international, non-profit, non-partisan, independent public policy research organization that is funded exclusively through unrestricted private sector donations sourced from charitable foundations, non-governmental organizations, for-profit organizations and individual supporters.
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Skinner, B.J. Waiting for Reimbursement of New Medicines in Canada. Pharmacoeconomics 26, 629–632 (2008). https://doi.org/10.2165/00019053-200826080-00001
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DOI: https://doi.org/10.2165/00019053-200826080-00001