Statement: Health insurers are working to improve patient care through Preferred Provider Networks

(Toronto, April 10, 2024) The Canadian Life and Health Insurance Association (CLHIA) has issued the following statement in response to recent media coverage about Preferred Provider Networks (PPNs) that have not adequately described the benefits these networks provide in terms of patient care and cost management. 

There are several different models of PPNs. Canadians who rely on specialty medications to help them manage complex health needs benefit from preferred provider networks. PPNs include protocols to support both continuity of care and a high-quality support and care for patients. For instance, through PPNs patients are able to access health services such as tools that will help them manage their condition and monitor their drug utilization. 

In 2022, approximately one per cent of claims were for specialty drugs. However, specialty drugs now account for 27 per cent of total drug spending. PPNs help patients to administer properly the specialty medications they have been prescribed – some of which cost over $1 million per year. 

PPNs help to ensure that Canadians who need life-saving medication and other supports can receive them, while also preserving the sustainability of benefit plans. Insurers believe they have a responsibility to help keep drug costs affordable for employers who offer workplace benefit plans to their workers. If drug costs continue to rise, they may become difficult to fund, potentially putting drug coverage at risk.

The CLHIA and our members believe that access to affordable medication for all Canadians should be a priority. PPNs help keep costs manageable while delivering high quality support and care for patients.