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  June 2010

Life and Health Insurance Industry Fact Sheet

Drug Reform in Ontario

1. It's all about fair drug pricing - Ontarians are paying too much for generic drugs

  • Spending on prescription drugs has grown faster than any other category of health expenditures, with the cost to employers providing drug benefits more than doubling over the past decade.
  • The 2008 Canadian Generic Drug Sector Study released by the Competition Bureau concluded that generic drug prices are higher in Canada compared to other countries and Canadians are not benefitting from competition in the generic market.
  • Canadians pay up to 5 times more for generic drugs than anywhere else in the world.
  • There is a perception that a generic drug should cost considerably less than a brand name drug. Following the regulation of generic drug pricing for the public Ontario Drug Benefit Program (ODB) in 2006, new generics were introduced for that plan at 50% of the brand price. Private payers were charged much more ­ as much as 95% in one case (Lisinopril).

2. Lower drug prices are important for all Ontarians

  • All Ontarians should have access to lower prices for generic drugs whether they are covered by the Ontario Drug Benefit Plan, by employer benefit plans or have to pay out of their own pockets.
  • 8.6 million Ontarians are covered by private (group and individual) benefit plans. These plans paid more than $4.1 billion for drug claims in 2008.
  • Close to 70% of private prescription drug spending in Ontario is delivered through group benefit plans; however not all employers in Ontario are in a position to offer drug plans.
  • Ontarians with no coverage paying the full cost of their drugs often pay the highest prices because they have no pricing controls in place to protect them and no ability to negotiate prices with pharmacies or manufacturers. By lowering overall generic drug costs, all Ontario residents will benefit.