Understanding the Gap 2.0: A Pan-Canadian Analysis of Prescription Drug Insurance Coverage

The Conference Board of Canada, 22 pages, July 13, 2022
Data Briefing by , ,
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This data briefing, an update to The Conference Board of Canada’s 2017 Understanding the Gap, analyzes the availability of prescription drug coverage across the country and the key issues in gaps in access to medication.

Document Highlights

  • We estimate that more than 36.8 million Canadians (or 97.2 per cent of the population) are eligible for some form of prescription drug coverage.
  • This leaves a 2.8 per cent gap in prescription coverage, which is almost half the 5.2 per cent gap we estimated in 2016.
  • The introduction of OHIP+ is helping close the gap in Ontario and nationally. Since 2016, 1.3 million children and youth under 25 years of age have become eligible for public drug coverage.
  • After accounting for private coverage, 3.8 million Canadians are not enrolled in a plan for which they are eligible. This represents 10.1 per cent of the population, down from 11.3 per cent in 2016.
  • Despite widespread access to drug coverage, some Canadians do not have sufficient access to medications. Key issues include public versus private differences in access to medications, delayed public access to new or innovative drugs, and out-of-pocket costs.

Table of Contents

Key Findings
The Gap in Prescription Drug Coverage Is Closing
OHIP+ Drives Boost in Coverage
One in 10 Canadians Remain Unenrolled
Underinsurance and Access Issues
Appendix A—Methodology
Appendix B—Bibliography

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