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Major health-focused charities advocate for Canada-wide prescription drug plan

Blood-testing strips for diabetics can cost as much as $1 each, in the current system. (Reuters)
Blood-testing strips for diabetics can cost as much as $1 each, in the current system. (Reuters)

Despite having a universal health-care system, Canada is the only developed nation with such a program that doesn’t provide universal coverage of prescription drugs. This is hitting cash-strapped Canadians hard: many can’t afford their prescription drugs, and they’re compensating by skipping doses, splitting pills, or simply not filling their prescriptions at all.

With the election only a few weeks away, several large health organizations are calling on the federal parties to make the national Pharmacare program a priority. To date, only the Green Party has announced universal access to necessary medicines as part of its platform, although the NDP have announced they’d like to discuss with the provinces how to work towards a national Pharmacare plan.

“Pharmacare is particularly important for people with diabetes because they require medication to control their disease and to prevent the risk of downstream complications,” says the Canadian Diabetes Association’s chief science officer Jan Hux, referring to conditions such as kidney failure, stroke, blindness and amputation. “Being able to take medications as prescribed is a really important way to prevent those complications.”

Drugs costs for people with diabetes vary widely depending on what drug regimen they’re on and what province they live in, but insulin can cost around $100 a month; another drug costs $300 a month.

People with diabetes also have to pay out of pocket for supplies like blood-sugar test strips, used daily, that can cost up to $1 each. Some provinces offer catastrophic coverage if drug costs exceed a certain portion of income, but many people on low incomes won’t hit that threshold, Hux says, because they’re balancing the cost of medications versus things like food and school supplies.

“We did a survey a few years ago that found that 57 per cent of Canadians don’t take their medications as prescribed because they can’t afford to,” Hux adds. “We estimate that almost all Canadians face [drug] costs of almost $1,500 a year….In this election campaign we’re asking for universal drug coverage, for fair and equitable access for people across Canada to medications.”


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Twenty-three per cent of Canadians report that they or someone in their household has skipped doses, split pills, or not filled a prescription in the past year to save money, according to a survey released in July by the Angus Reid Institute and the Mindset Social Innovation Foundation. It also found that more than one in three said they have friends or family members who have financial difficulty paying for their prescriptions.

The Heart and Stroke Foundation is another organization that supports universal drug coverage.

“The three most dispensed medications for cardiovascular disease in 2010 were statins, diuretics, and ACE inhibitors,” says Lesley James, senior health policy analyst at the Heart and Stroke Foundation. “Frequently, benefit plans do not cover the entire cost of medications, meaning that it is still sometimes difficult for people with insurance coverage to afford medications. Access to prescriptions drugs is a major issue for many Canadians as 3.4 million Canadians were either under insured or were not insured at all for out of hospital prescription drugs [in 2010].

“Non-adherence to drug prescriptions--failure to fill prescriptions or to follow instructions--which can be the result of financial barriers, has been associated with significant increases in mortality, hospitalizations, and costs,” she adds. “When they are used appropriately, they help to save lives and improve quality and quantity of life. Prescription drugs also shorten and in some cases prevent time spent in hospitals. This is not only good for patients, but also results in more manageable workloads for health care providers and potentially, decreased costs for health care facilities and other aspects of health care.”

Although the Canadian Cancer Society hasn’t taken a formal position on universal drug coverage, director of public issues Gabriel Miller says it’s clear that the current system isn’t working.

“There’s a very clear consensus that the current approach to paying for and providing prescription drugs in Canada is problem and it’s far too great a burden on patients, families, and employers, and it’s not especially effective,” Miller says.

In the Canadian Cancer Society’s 2009 Cancer Drug Access for Canadians report, the price tag of the average cost per course of treatment with newer cancer drugs is $65,000. Three-quarters of the new cancer drugs are taken at home, which means either the patient or the insurance company must pay for it. If private insurance is available, 100 per cent of the drug cost is not always covered. Private plans typically require a co-payment for prescription drugs and may have an annual maximum that is significantly below a normal course of cancer treatment. So someone with cancer may be liable for up to $13,000 for an average course of treatment for a newer drug.

Steve Morgan, a lead author of the recently released report Pharmacare 2020: The future of drug coverage in Canada report, says that the call for universal drug coverage is hardly new.

“We’ve been waiting for this since the 1960s, when the Royal Commission on Health Services recommended we have universal drug coverage,” says Morgan, a professor in the School of Population and Public Health at UBC. “We’re hoping that a federal party will say ‘the time has come.’ I implore the parties to step up, because this is a win-win. Citizens win and the economy wins. It just requires leadership.”

Opposition, Morgan says, comes from groups that stand to lose money, such as drug manufacturers, which are currently able to charge more for drugs in Canada than in other developed nations, and the private insurance industry. However, a universal system would not eliminate the need for private insurance altogether; there would still be a demand for private coverage of drugs not deemed medically necessary and private companies could still play administrative roles. Alberta Blue Cross, for example, administers several health programs on behalf of the Government of Alberta.

The Canadian Medical Association General Council recently voted 92 per cent in favour of a universal program. Even municipalities are starting to speak out. The City of Burnaby, for example, recently adopted a resolution calling a universal public health care system that includes the cost of prescription medicines.

What’s needed to make universal drug coverage reality, Morgan says, is political will at the federal level as well as public insistence.

“You need a federal government that wants to show leadership,” Morgan says. “What will motivate them is the fury of the general public who will say ‘We no longer wish to have a government that won’t stand up for us. We want change. What will motivate government is when the average Canadian says ‘we can’t tolerate this any longer.’”