Pharmaceutical Pricing and Reimbursement Policies in Canada
In Canada, drug expenditures have been increasing very rapidly in recent years. The regulation of patented pharmaceutical products by the Canadian federal government has very likely been responsible for bringing prices for patented medicines roughly in line with European comparators. Prices of generic products, which are not regulated, are relatively high although high penetration of the Canadian market has been achieved. While drugs administered in hospitals are covered through the universal, publicly financed Medicare programme, other prescription drugs are not included among the insured benefits guaranteed by the Canada Health Act. Consequently, about two-thirds of Canadian residents are covered for prescription drugs by private insurance obtained through their employer or purchased on an individual basis, while most senior citizens, together with designated groups of vulnerable populations, are covered by provincial, territorial or federal plans. According to estimates for 2000, 98% of the Canadian population has some form of public or private sector drug plan coverage that provides a degree of protection against severe drug expenditures. Moreover, it was estimated in 1998 that 10% of the Canadian population was uninsured for routine expenditures, in the sense that they would have to pay every dollar of the first CAN$1,000 if they had to face such expenditures. In most cases, patients share in the costs of reimbursed medicines through copayments or co-insurance, sometimes after meeting a deductible. About 54% of drug expenditures are financed by private insurances and households.
