In this issue
Key survey findings:
- Who were the Survey respondents?
- Key Survey Findings
- Experience of respondents on advanced therapies
- Research-based recommendations for private health industry
JointHealth™ insight Published December 2024
Private health insurance plays an important role in the lives of people with arthritis living in Canada. Private health insurance typically provides coverage for medications and other essential services to help people manage their osteoarthritis and/or inflammatory arthritis (like rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, and lupus). Arthritis Consumer Experts (ACE) surveyed its arthritis community members to better understand their experiences and challenges with their private health insurance plan, with close attention paid to the experience of Black, Indigenous, person of colour (BIPOC) and those currently receiving reimbursement coverage for a biologic
(originator or biosimilar) medicine.
Who were the Survey respondents?
Listening to you
We hope you find this information of use. Please tell us what you think by writing to us or emailing us at feedback@jointhealth.org. Through your ongoing and active participation, ACE can make its work more relevant to all Canadians living with arthritis.
Update your email or postal address
Please let us know of any changes by contacting ACE at feedback@jointhealth.org. This will ensure that you continue to receive your free email or print copy of JointHealth™ insight.
Arthritis Consumer Experts (ACE)
Who We Are
Arthritis Consumer Experts (ACE) and its team members acknowledge that they gather and work on the traditional, ancestral and unceded territory of the Coast Salish peoples -ʷməθkʷəy̓əm (Musqueam), Sḵwx̱wú7mesh (Squamish), and Səl̓ílwətaʔ/Selilwitulh (Tsleil-Waututh) Nations.
Arthritis Consumer Experts (ACE) operates as a non-profit and provides free research based education and information to Canadians with arthritis. We help (em)power people living with all forms of arthritis to take control of their disease and to take action in healthcare and research decision making. ACE activities are guided by its members and led by people with arthritis, scientific and medical experts on the ACE Advisory Board. To learn more about ACE, visit www.jointhealth.org
Disclosures
Over the past 12 months, ACE received financial and in-kind support from: Amgen Canada, Arthritis Research Canada, Arthritis Society Canada, Biogen Canada, Canadian Biosimilars Forum, Canadian Rheumatology Association, Celltrion Healthcare Canada, JAMP Pharma, Novartis Canada, Organon Canada, Pfizer Canada, Sandoz Canada, UCB Canada, and the University of British Columbia.
ACE also received unsolicited donations from its community members (people with arthritis) across Canada.
ACE thanks funders for their support to help the nearly 6 million Canadians living with osteoarthritis, rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis and the many other forms of the disease.
Disclaimer
The material contained on this website is provided for general information only. This website should not be relied on to suggest a course of treatment for a particular individual or as a substitute for consultation with qualified health professionals who are familiar with your individual medical needs. Should you have any healthcare related questions, you should contact your physician. You should never disregard medical advice or delay in seeking it because of something you have read on this or any website.
This site may provide links to other Internet sites only for the convenience of World Wide Web users. ACE is not responsible for the availability or content of these external sites, nor does ACE endorse, warrant or guarantee the products, services or information described or offered at these other Internet sites.
Although the information presented on this website is believed to be accurate at the time it is posted, this website could include inaccuracies, typographical errors or out-of-date information. This website may be changed at any time without prior notice.
Understanding the Private Health Insurance Experience for People with Arthritis Living in Canada
Private health insurance plays an important role in the lives of people with arthritis living in Canada. Private health insurance typically provides coverage for medications and other essential services to help people manage their osteoarthritis and/or inflammatory arthritis (like rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, and lupus). Arthritis Consumer Experts (ACE) surveyed its arthritis community members to better understand their experiences and challenges with their private health insurance plan, with close attention paid to the experience of Black, Indigenous, person of colour (BIPOC) and those currently receiving reimbursement coverage for a biologic(originator or biosimilar) medicine.
Who were the Survey respondents?
- 170 respondents (English and French)
- 66% identified as women / 32% as men
- 1 in 5 respondents identified as BIPOC
- 48% of respondents live in large urban centres / 16% in small-medium sized communities / 13% in rural or remote communities
- 146 respondents reported that they were currently receiving private health insurance reimbursement coverage for an originator biologic (65), biosimilar biologic (45), or targeted synthetic DMARD (36)
Ease of reimbursement |
Support services |
Delays and declines |
Preauthorization challenges |
Affordability of coverage |
BIPOC Experiences |
Experience of respondents on advanced therapies
|
Getting medication reimbursement coverage for more costly biologics (originator and biosimilar) is even more challenging and often requires going through a confusing administrative process with a stream of complicated paperwork. Some private drug plans have begun introducing policies to expand the use of biosimilars to reduce healthcare costs while maintaining or improving care. There were no significant differences in the experience of respondents receiving coverage for biosimilars and those on originator biologics in the areas of affordability, access to care, and patient support services. |
Survey respondents currently on originator or biosimilar biologics report same degree of changes with...
 |
Impacts on arthritis care
|
Private health insurance plan members living with arthritis face serious obstacles, including...  |
Research-based recommendations for private health insurance industry
Comprehensive coverage
|
Listening to you
We hope you find this information of use. Please tell us what you think by writing to us or emailing us at feedback@jointhealth.org. Through your ongoing and active participation, ACE can make its work more relevant to all Canadians living with arthritis.
Update your email or postal address
Please let us know of any changes by contacting ACE at feedback@jointhealth.org. This will ensure that you continue to receive your free email or print copy of JointHealth™ insight.
Arthritis Consumer Experts (ACE)
Who We Are
Arthritis Consumer Experts (ACE) and its team members acknowledge that they gather and work on the traditional, ancestral and unceded territory of the Coast Salish peoples -ʷməθkʷəy̓əm (Musqueam), Sḵwx̱wú7mesh (Squamish), and Səl̓ílwətaʔ/Selilwitulh (Tsleil-Waututh) Nations.
Arthritis Consumer Experts (ACE) operates as a non-profit and provides free research based education and information to Canadians with arthritis. We help (em)power people living with all forms of arthritis to take control of their disease and to take action in healthcare and research decision making. ACE activities are guided by its members and led by people with arthritis, scientific and medical experts on the ACE Advisory Board. To learn more about ACE, visit www.jointhealth.org
Disclosures
Over the past 12 months, ACE received financial and in-kind support from: Amgen Canada, Arthritis Research Canada, Arthritis Society Canada, Biogen Canada, Canadian Biosimilars Forum, Canadian Rheumatology Association, Celltrion Healthcare Canada, JAMP Pharma, Novartis Canada, Organon Canada, Pfizer Canada, Sandoz Canada, UCB Canada, and the University of British Columbia.
ACE also received unsolicited donations from its community members (people with arthritis) across Canada.
ACE thanks funders for their support to help the nearly 6 million Canadians living with osteoarthritis, rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis and the many other forms of the disease.
Disclaimer
The material contained on this website is provided for general information only. This website should not be relied on to suggest a course of treatment for a particular individual or as a substitute for consultation with qualified health professionals who are familiar with your individual medical needs. Should you have any healthcare related questions, you should contact your physician. You should never disregard medical advice or delay in seeking it because of something you have read on this or any website.
This site may provide links to other Internet sites only for the convenience of World Wide Web users. ACE is not responsible for the availability or content of these external sites, nor does ACE endorse, warrant or guarantee the products, services or information described or offered at these other Internet sites.
Although the information presented on this website is believed to be accurate at the time it is posted, this website could include inaccuracies, typographical errors or out-of-date information. This website may be changed at any time without prior notice.
Arthritis Consumer Experts
ACE thanks Arthritis Research Canada (ARC) for its scientific review of ACE and JointHealth™ information and education programs.