Study finds significant overlap in the drugs covered by Canadian public drug plans

October 11, 2017

Ottawa, ON — Patented Medicine Prices Review Board

The Patented Medicine Prices Review Board (PMPRB), through the National Prescription Drug Utilization Information System research initiative, today published Alignment Among Public Formularies in Canada - Part 1: General Overview. This is the first report in a three-part series that compares drug coverage across provincial and federal public drug plans.

This report compares the lists of drugs covered by the public plans in 2015 and determines the extent to which they overlap. It also examines the degree of overlap among plans for specific market segments including generic drugs and branded products, high-cost drugs, and a specified list of drugs that experts believe are essential to the Canadian health care system.

The report found that public drug plan formularies listed a fairly high percentage of the drugs in question, especially for the list of essential medicines. In general, generic drugs had higher listing rates than branded products. The variation among public plans was greatest for high-cost drugs.

Alignment Among Public Formularies in Canada - Part 1 is available on the PMPRB website in PDF and accessible HTML formats. Parts 2 and 3 of the series will focus specifically on newer non-cancer drugs evaluated for their cost-effectiveness via the Common Drug Review (CDR) and cancer drugs evaluated via the pan-Canadian Oncology Drug Review.

Quick Facts

  • The PMPRB study looked at a total of 729 drugs, accounting for 82% of the total public drug costs in 2015.
  • Individual public plans listed an average of 79% of the selected drugs in 2015, with the remaining drugs accounting for only 5% of the cost.
  • Of the 729 drugs, 125 are considered essential medicines and an average of 92% of them are covered across all public plans.
  • Drugs with generic availability, which often have higher use and lower cost, had an average listing rate of 86%.
  • Listing rates for brand products without generic availability were lower, with an average of 67% across all plans. The plans tend to set certain conditions for these products, especially for the high-cost drugs.

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