Prescription drug affordability is becoming a cost-of-living and access-to-care issue. It is also part of the broader conversation about prescription drugs in Canada, where national pharmacare, private insurance, provincial formularies, and out-of-pocket costs all shape how, if, and how much people access medicines.
Leger Healthcare’s newest national survey finds that most prescription users surveyed have some form of drug coverage, but many still report financial pressure. For many Canadians, the issue is not only whether their prescription is covered, but whether that coverage is enough to keep medications affordable enough to use them as prescribed.
These findings point to a clear challenge for governments, insurers, employers, benefits providers, healthcare professionals, and pharmaceutical companies: coverage gaps remain, and even among drug categories with some coverage, out-of-pocket costs remain a struggle for many Canadians.
Key Findings
Among Canadians who have taken a prescription medicine in the past 12 months:
- 90% have public and/or private prescription drug coverage.
- 1 in 4 say prescription costs are a moderate or large financial burden.
- 1 in 3 say prescription costs are more of a burden than they were five years ago.
- 37% have cut back on household spending because of prescription costs.
- 27% have delayed, reduced, or avoided a prescription because of cost.
- Young adults surveyed are among the most affected by out-of-pocket prescription costs.
- Among respondents who identified a GLP-1 medication as their highest out-of-pocket prescription cost, reported burden was comparatively high.
- Doctor and pharmacist recommendations are among the top factors influencing whether prescription users surveyed would switch from a brand-name medicine to a generic or stay on brand.
Coverage Does Not Always Mean Affordability
Most Canadians who take prescription medication have some form of coverage. Among prescription users surveyed, 41% have private-plan-only coverage, 35% have government or public plan-only coverage, and 14% have both private and public coverage. Only 9% report having no prescription medicine coverage. This is important because Canada’s public and private drug plans vary by payer, province or territory, eligibility, formulary coverage, and patient cost-sharing.
But coverage does not eliminate cost pressure. Twenty-four percent of prescription users surveyed say prescription medicine costs have been a moderate or large financial burden in the past 12 months. And for many, the situation has become more difficult: 32% say prescription costs are more of a burden than they were five years ago.
This points to an important distinction: the issue is not only whether Canadians have drug coverage, but whether that coverage is enough to keep medications affordable.
The Affordability Threshold Is Low for Many Canadians
For many prescription users surveyed, current monthly out-of-pocket costs are under $50. However, the survey suggests that a relatively low monthly cost can still become a barrier.
One in four prescription users say the highest monthly out-of-pocket cost they could afford before avoiding a prescription is under $50. Nearly half place that affordability threshold below $100 per month.
This has implications for drug plans, benefits design, patient support programs, and access strategies. The difference between a manageable and unaffordable prescription may be smaller than many assume.
Prescription Costs Are Affecting Household Budgets and Medication Use
Prescription affordability is also connected to broader household financial pressure.
More than one-third of prescription users surveyed say they have reduced household spending because of prescription drug costs. These cutbacks include spending on groceries or food, rent and utilities, transportation, savings or debt payments, other healthcare, leisure, and family expenses.
The impact is especially pronounced for younger adults surveyed. Among Canadians aged 18 to 34 who have taken a prescription in the past 12 months, six in ten say they have cut back on household spending because of prescription costs.
This suggests that prescription affordability is not only a healthcare issue. For many prescription users surveyed, it is part of the larger cost-of-living conversation.
Cost Is Changing How Some Canadians Use Their Prescriptions
Prescription costs are also affecting how some prescription users surveyed manage their medication and whether they take it as prescribed.
More than one-third of prescription users report doing at least one of the following because of cost: waiting longer to fill or refill a prescription, taking less medicine than prescribed, stopping refills, not filling a new prescription, switching to a generic or lower-cost version, or using savings, credit, or borrowed money to pay for medication.
More specifically, 27% say they have delayed, reduced, or avoided a prescription because of cost.
These findings matter because even relatively modest out-of-pocket costs can affect whether people fill, refill, or take prescriptions as directed.
Some Medication Categories Carry Greater Financial Pressure
The survey also asked respondents with out-of-pocket prescription costs which type of medication accounts for the biggest share of those costs.
Cardiovascular medications — including heart health, blood pressure, and cholesterol medicines — were the most commonly reported category. Respondents using cardiovascular medications were also most likely to indicate their out-of-pocket costs were no burden at all, and they were the least likely to avoid taking their medication.
By contrast, respondents who identified a GLP-1 medication as their highest out-of-pocket prescription cost reported comparatively higher levels of financial burden and were more likely to take less medication than prescribed, delay, or stop refilling a prescription.
The data suggests that prescription affordability pressure is not evenly distributed. It varies by medication type, patient profile, and coverage situation.
Switching to Generics Depends on Trust as Well as Price
The survey also examined what would influence prescription users surveyed to switch from a brand-name medicine to a lower-cost generic. Health Canada reviews drug products before they are authorized for sale in Canada and assesses them for safety, efficacy, and quality. More broadly, Health Canada also plays a role in regulating health products to help ensure products meet Canada’s safety and quality standards.
While lower out-of-pocket cost is important, the leading influence is doctor advice. Respondents were most likely to say they would consider switching if their doctor said the generic would work just as well for them. Pharmacist advice and clear information that the generic is safe and effective are also important factors.
Doctor input also plays a major role in decisions to stay on brand. When asked what would make them most likely to stay with the brand-name version of their most expensive prescription, respondents again ranked doctor recommendation as the top factor. Pharmacist recommendation, cost similarity, and stability on the brand-name medicine also mattered.
This shows that brand/generic decisions are not driven by price alone. Trust, reassurance, and healthcare provider guidance are central to how Canadians think about switching.
Why These Findings Matter
For prescription users surveyed, affordability is increasingly connected to household financial pressure and access to care. Even among those with coverage, out-of-pocket costs can influence whether medications are filled, refilled, or taken as prescribed.
For governments, insurers, employers, and benefits providers, the findings point to the importance of looking beyond whether people are covered and focusing on whether coverage is sufficient. Out-of-pocket thresholds, plan design, and support for lower-cost alternatives may play an important role in reducing cost-related barriers. These findings also provide timely context for policy discussions about national pharmacare, provincial and territorial drug programs, and employer-sponsored benefits.
For pharmaceutical companies, affordability is directly tied to access, persistence, and brand/generic decision-making. Understanding where cost pressure is concentrated — by demographic group, insurance type, and highest-cost drug category — can help inform access strategy, patient support, and communication with healthcare professionals.
More Detailed Findings Are Available
The full report includes detailed breakdowns by:
- Insurance coverage
- Highest-cost drug category
- Age
- Region
- Rural, urban, and suburban area
- Household income
- Education
- Ethnicity
Methodology
This online survey was conducted from May 1 to May 3, 2026, among 1,518 Canadians aged 18 or older. Respondents were randomly recruited through Leger’s LEO online panel and had the option of completing the survey in English or French.
Respondents who indicated they had not taken any prescription medications in the past 12 months, or were unsure, were excluded from the remainder of the survey, leaving a sample of 1,062 respondents for most prescription-related questions.
Results were weighted by age, gender, region, education, and presence of children in the household to reflect the Canadian adult population.
A margin of error cannot be calculated on a non-probability sample. For comparison purposes, a probability sample of 1,062 respondents would have a margin of error of ±3.0%, 19 times out of 20.
Leger is a member of the Canadian Research Insights Council, and this research was completed in compliance with CRIC standards.
