Through its 22-member insurance companies, the Canadian Drug Insurance Pooling Corporation's (CDIPC) high-cost drug framework provided insurance for more than 15,000 Canadian employers and more than 32,000 individuals and families whose annual drug costs exceeded $10,000 in 2022, stated the organization in a March 7 press release.
The CDIPC revealed that individuals and families benefiting from high-cost drugs represented only 1.6 per cent of insured persons, however the cost of their medications accounted for 36 per cent of all drugs paid in 2022.
In its press release, the CDIPC also reported that 38 new drugs were reimbursed by member insurance companies in 2022, compared to 48 in 2021. The organization underlined, however, that although the number of new drugs decreased, the average annual amount reimbursed to plan members for these new drugs increased from $44,700 in 2021 to $60,900 in 2022, or by 36 per cent.
Most significant year-over-year jump
"The increase in the average cost for new drugs in 2022 was the most significant year-over-year jump that CDIPC member companies have seen since its inception in 2012,” stated Dan Berty, CDIPC's Executive Director. “Because it takes two to three years to see the full uptake of new drugs by patients and their effect on the pool, we expect the drugs first claimed in 2022 to have already had a very material impact on 2023's high-cost drug experience."
Berty added that while the number of plan members dipped in 2021 year-over-year, they were back on the rise in 2022. “This is a trend we expect to continue and is reflected in pooling premiums from insurers," he said. "Despite this trend, and related pooling charge pressures, CDIPC's EP3 (Extended Healthcare Policy Protection Plan) pooling continues to shield small, mid-size, and some larger employers from the full impact of high-cost drug claims."
The CDIPC was formed by Canada's life and health insurers in 2012. The not-for-profit corporation aims to maintain sustainable drug coverage by pooling recurring high-cost drugs claims from individuals belonging to drug plans.
