1. Pharmaceutical Overview 20

2. Pharmaceutical Overview Pharmaceuticals are covered through public or private insurance Within a hospital setting drugs administered are covered through public insurance Provinces and territories offer pharmaceutical insurance plans Plans differ in eligibility, premiums, coverage and formulary design Canada top-10 pharmaceutical market in the world – per capita spending 2 nd highest in the world Strong growth in per capita pharmaceutical spending since 1990s Between 2000-2010 per capita spending almost doubled from USD 400.7 to USD 740.7 (PPP) 21

3. Pharmaceutical Snapshot Total spending on pharmaceuticals in 2011 C$32billion (CIHI) Growth of 4% 2010-2011 Lower growth than in the past but still close to TEH AAGR Prescription drugs account for close to 85% of total spending Relatively even split between public and private financing of prescription drugs: 45% vs. 55% Stronger growth rates in private financing (6.8%) vs. public financing (2.2%) Large variations in per capita spending from province to province: C$576 in British Columbia and C$710 in Manitoba vs. C$937 in New Brunswick and C$985 in Nova Scotia Large variations in spending growth from province to province: 1.4% in British Columbia and 2% in Ontario vs. 7.4% in Saskatchewan and 9.4% in Newfoundland and Labrador 22

4. Total Expenditure on Pharmaceuticals and Other Medical Non-durables, % TEH, Canada, 1960-2010 23 Source: OECD Stat (2012) 18 16 14 12 10 8 6 4 2 0 20 19601965197019751980198519901995200020052010

5. 15 10 Total Expenditure on Pharmaceuticals, % of TEH, 1990-2009, Canada and Select OECD Countries 25 20 5 Source: OECD Stat (2012) 0 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 24 Canada United States Germany Japan France

6. 25 (2012) 200 100 0 Total Per Capita Spending, Pharmaceuticals and Other Medical Non-durables, US$ PPP, Canada, 1980-2010 800 700 600 500 400 300 Source: OECD Stat 1980198219841986198819901992199419961998200020022004200620082010

7. Total Per Capita Spending, Pharmaceuticals and Other Medical non-durables, US$ PPP, 2010 or Closest Year, OECD 26 Source: OECD Stat (2012) 0 100 200 300 400 500 600 700 800 900 1000