Gaps in prescription drug coverage are placing millions of Canadians at risk of financial hardship. In challenging economic times, this inequity is even more glaring. It is not uncommon for annual drug costs to run into tens of thousands of dollars. This means that many Canadians are unable to get the essential prescription drugs they need without undue financial stress.
Canadians understand that pharmaceuticals help to improve their health. But few are aware of their multi-billion-dollar cost or spend time considering who pays for them and who has—or doesn’t have—access.
Particularly when times are tough, we need to remind ourselves of the fundamental beliefs that we share around healthcare in general and access to pharmaceuticals in particular. This includes ethical issues, such as if it is fair that someone is covered for essential medication in one province but not another. For example, in January 2010, the Globe and Mail described unequal access to cancer drugs as a “postal code lottery.”
How we provide access to drugs helps to define who we are as a nation. We need to develop a new framework for pharmaceutical coverage in Canada to keep all Canadians on a level playing field, because the statistics aren’t looking good.
• Canadians with poor access to necessary drugs are elevating overall costs to the healthcare system through emergency room visits and other costly interventions.
• In 2008, the Canadian Institute of Health Information (CIHI) estimated that Canadians spent $25.14 billion on prescription drugs.
• A 2007 survey in Health Affairs found that one in 12 Canadians had not filled a prescription or had missed a dose of medicine in the previous year because of cost—and this survey was completed before the recession.
• Prescription drugs have ranked second in terms of overall health expenditure since 1997, according to the CIHI.
• The government covers less than 40% of drug costs; the rest is in the hands of employers, unions and individual consumers.
The Canadian Council on Integrated Healthcare, a national multi-stakeholder forum that encourages constructive dialogue on health-related issues, believes that Canada must move toward a new framework of access to pharmaceuticals—one that doesn’t impose undue financial hardship on Canadians. All Canadians must have equitable and reasonable access to prescription drugs that are considered an essential component of evidence-based treatment.
Federal, provincial and territorial governments must act now to foster this change by:
• providing incentives and funding to ensure that Canadians in every province and territory have access to basic coverage for essential drugs, where the cost to an individual does not exceed 5% of his or her net income;
• encouraging an integrated approach by governments, individual Canadians and employers while recognizing that individual provinces and territories will have unique design solutions based on their own priorities; and
• using tax, expenditure and regulatory levers to achieve an integrated national solution to pharmaceutical coverage.
There is a clear and growing problem around access to life-saving and life-altering drugs in Canada. The economic, social, health and ethical costs associated with this lack of access are too important to ignore. We need integrated drug plan partnerships between governments, insurers, employers, employees and patients. Only then will the playing field become level. BC
Caroline Brereton, RN, is a member of the Canadian Council on Integrated Healthcare.
cbrereton@leanhealthcareservices.ca
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© Copyright 2010 Rogers Publishing Ltd. This article first appeared in the April 2010 edition of BENEFITS CANADA magazine.