Diabetes and Diabetes-Related Out-of-Pocket Costs

Since 2003 Diabetes Canada has tracked the out-of-pocket costs of managing type 1 diabetes and type 2 diabetes to illustrate the impact these costs have on people.

These costs, last updated in 2015, are the focus of the Diabetes and Diabetes-Related Out-of-Pocket Costs 2022 report, a research initiative conducted in partnership with Quantitative Economic Decisions, Inc (QEDinc). The research recognizes the growing range, advancement, and complexity of treatment options for people living with type 1 and type 2 diabetes to reflect individual lifestyles, budgets, and health issues.

The Canada Health Act states that all Canadians should receive reasonable access to publicly funded, medically necessary hospital and physician services. But medications and supplies used outside of hospitals are not publicly insured, and their cost can take a financial toll on people living with diabetes.

In Canada, the level of public coverage for diabetes medications, devices, and supplies varies significantly across provinces and territories, presenting real barriers to effective diabetes management which can compromise health outcomes. While advocacy has significantly enhanced public funding for the cost of medications, devices, and supplies for people living with both type 1 and type 2 diabetes, the out-of-pocket costs vary widely depending on place of residence, age, income, and other personal circumstances.

Key findings

Too many people living with diabetes in Canada are paying increasing costs for prescribed medications, devices or supplies.

Out-of-pocket costs for people living with type 1 diabetes can be as high as $18,306 per year in certain areas of Canada.
Out-of-pocket costs for people living with type 2 diabetes can be as high as $10,014 per year in certain areas of Canada.
Drug costs become “catastrophic” when they are more than 3% of a family’s annual income. Over half of people living with type 1 diabetes either experience costs above 3% of their family income or, given other financial burdens and lack of resources, fail to adhere to the treatment recommended by their doctor. This is likely also the case for people living with type 2 diabetes and will inevitably lead to poorer health outcomes for people.

Living with diabetes in Canada continues to be marked by health inequity as catastrophic out-of-pocket costs are especially acute for lower income groups and people affected by type 2.

People affected by diabetes tend to have lower income than the general population and so a substantial share of people living with type 2 diabetes are having to make very difficult choices between their health and paying their rent or buying groceries.
While government support is highest for low-income groups, the proportion of family income required to cover costs is also highest for this group.
While public funding substantially reduces or even eliminates the costs for diabetes medications, devices, and supplies for many families throughout Canada, there are unfortunately many people for which government plans only cover a small share of costs.
For nearly half of the type 2 provincial and territorial scenarios examined for this report, government plans cover less than 20% of total costs.

Out-of-pocket costs for people living with type 1 and type 2 diabetes continue to vary dramatically depending on where you live in Canada.

Type 1

Highest costs occur in New Brunswick for young people with family income of $150,000 and using insulin pumps and real-time continuous glucose monitoring.
Costs as a share of family income are highest in Prince Edward Island where they can account for up to 20% of income for adults and seniors with family income of $30,000 or more using an insulin pump and finger prick test and Quebec for adults with income of $30,000 or more also using an insulin pump and finger prick testing.
Lowest costs in Canada’s provinces occur in Alberta for young people with family income of $30,000 for all medication and medical device scenarios.

Type 2

The highest costs occur in New Brunswick for adults with family income of $150,000 and using oral medications that help manage blood glucose, multiple antihypertensive medications (AHT), insulin, and real-time continuous glucose monitoring.
Costs as a share of family income are highest in Ontario where they can account for 17% of income for adults with family income of $30,000 using oral medications that help manage blood glucose, insulin, multiple AHT medications, and real-time continuous glucose monitoring.
The lowest costs in Canada’s provinces occur in Alberta for young people with family income of $30,000 using oral medications that help manage blood glucose, insulin, and finger prick testing.