High drug expenses in Canada are a significant barrier for people to access prescription drugs outside of hospital, states an analysis article in Canadian Medical Association Journal (CMAJ). The article, written by University of Calgary researchers was published on September 16.
Canada lacks a national pharmacare program so drug costs are borne by patients themselves, as well as a mix of private and publicly funded drug plans. Even those with insurance may face difficulties affording medications as most insurance plans require copayments by patients, thereby presenting a barrier to accessing needed drugs. While provincial governments cover most or all drug costs for seniors and those receiving social assistance, the “working poor” (households with an annual income less than $29,999) do not have the same benefits, which can result in high rates of noncompliance and failure of patients to fill their prescriptions.
“Some could rightly say that inadequate drug access is the most significant shortcoming of Canada’s health-care system,” says Dr. Braden Manns, a coauthor on the analysis, and a member of the university’s Institute for Public Health and Libin Cardiovascular Institute of Alberta. “Without better drug coverage systems, we do not have universal health coverage.”
There are many factors that influence patient-related drug expenses in Canada, including federal and provincial/territorial governments, insurers and physicians. Physicians for example, are often unaware of the difference in costs between two drugs with similar efficacy. They may prescribe a more expensive drug without recognizing the financial burden it may impose onto a patient.
The authors recommend several possible solutions to these barriers including creating a national drug agency, changing the way Canada regulates patented drug prices, differential copayments for medications based on ability to pay or clinical value of a drug, and educating physicians on drug costs.
“A national drug agency would be well-positioned to implement a universal drug program, where all Canadians would have access to some type of drug coverage,” says Dr. Karen Tang, article coauthor and member of the university’s Institute for Public Health. “We do however acknowledge that there would be barriers to implementing a national plan.”
Researchers in this study are funded by Alberta Innovates – Health Solutions.