CLHIA-ACCAP

Canadian Life & Health Insurance Facts // 2025 Edition 15 Prescription drug claims grew 8 per cent in 2024 Supplementary health insurance plans provided 27 million people with access to a wide range of prescription drugs, including specialty medications to treat serious, chronic, and complex health conditions. Drug claims grew by about 8 per cent in 2024 as both coverage and the number enrolled in workplace plans increased. Drugs to treat inflammatory conditions, diabetes, asthma, chronic obstructive pulmonary disease, cancer, as well as depression, accounted for over a third of all drug benefits paid.* Insurers are making high-cost drugs more affordable through pooling for small and medium- sized employers Costing millions each year, the price of some high-cost drugs can be a significant burden for group benefit plans. That's why many CLHIA members work together to spread these costs over several plans through the Canadian Drug Insurance Pooling Corporation (CDIPC). Health Insurance L I N E S O F B U S I N E S S *Express Scripts. 2025 Drug trends report In 2023, the 21- member insurance companies belonging to CDIPC's high-cost drug framework provided Extended Policy Protection Plans (EP3s) to almost 17,000 employers who had at least one employee with annual drug costs exceeding $10,000. High-cost drug inflation outpaced the Consumer Price Index for 2023 by almost 400%. Despite this, CDIPC member companies and private insurers continue to offer extensive drug coverage that often exceeds public coverage. CDIPC at a glance • EP3s benefited more than 36,000 employees and their families, whose annual out-of-pocket drug costs exceeded $10,000. • CDIPC's pooling framework of member companies eliminated over $946 million in out-of-pocket expenses to Canadians while maintaining the affordability of their drug plans. • 43 new high-cost drugs were made available through the pool in 2023.

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