Coverage of oncology medicines well aligned across Canadian provinces, but sources of funding differ

From: Patented Medicine Prices Review Board Canada

The Patented Medicine Prices Review Board (PMPRB), through the National Prescription Drug Utilization Information System (NPDUIS) research initiative, today published the second in a three part report series on Alignment Among Public Formularies in Canada. This latest report looks at gaps and overlaps in the coverage and funding of oncology drugs across Canada.

The report found that there is significant uniformity in the coverage of oncology drugs in public drug plans in Canada. However, there are notable differences across the country in who pays for these drugs when administered outside hospitals, which may have an effect on the financial burden felt by patients from province to province.

The current report is the first of its kind to map the variations in oncology spending and funding across the country and will be of particular interest to policy makers in their ongoing efforts to provide more equitable and affordable access to drugs for all Canadians.

Quick facts

  • The alignment across the country in terms of what oncology drugs are reimbursed by public plans is quite high, at an average of 84%.

  • When weighted by sales, alignment is even higher, at 96%, which means that the medicines not commonly covered by public plans account for only a small share of national sales.

  • The payer split for oncology drugs administered outside of the hospital varies significantly by province, because of differences in eligibility for public drug plan coverage.

  • Publicly insured patients’ contributions to the costs of their take-home oncology drugs differ depending on where they live, though higher deductibles and co-pays in private plans mean that privately insured patients have higher average contributions overall.

/Public Release. This material comes from the originating organization and may be of a point-in-time nature, edited for clarity, style and length. View in full here.