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

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.