CLHIA-ACCAP

Canadian Life and Health Insurance Facts -- 2017

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Cost-effective health insurance protection The industry pays out 86% of health insurance premiums as benefits to policyholders (this includes funds set aside for future benefits on disability and other longer-term contracts), 8% for operating costs and 3% in federal and provincial taxes. The remaining 3% is the average profit margin. Specialty drugs The development of specialized drugs has also led to a steep rise in drug costs. These specialty drugs, while making up 2% of the total number of claims, accounted for 30% of prescription drug costs in 2016, and the costs are expected to rise further in future years. 13 2016 health benefits $32.5B Ext. health 75% Disability 21% Other 4% Benefits by coverage type $11.0B Drugs $7.9B Dental $3.0B Paramedical* & vision Ext. health $1.8B Hospital $0.8B Travel *Refers to services and professions, such as physiotherapy, that supplement and support medical treatment 86% of premiums paid out as benefits (5-year average) The cost of specialty drugs is anticipated to reach 40% of prescription drug costs by 2022* 22% 30% 40% 2012 2016 2022 (estimated) *Source: Drug Trend Report, Express Scripts Canada Contents View provincial data View historical data

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