A research team at the nearby St. Michael’s Hospital is launching a study into prescription drug costs, a barrier, according to the Canadian Medical Association Journal, that keeps one in 10 Canadians from using medication as prescribed.
The “Carefully seLected and Easily Accessible at No charge Medications” (CLEAN) study will examine the health effects and institutional costs or benefits of providing free medication to patients in need.
“We see many patients who can’t afford medication and end up running into serious problems that could have been avoided with relatively inexpensive medication,” said lead researcher Dr. Nav Persaud.
The controlled trial of 800 low-income patients will provide one group of participants with free medication for a year. The other group will continue to access treatment as it usually would, without having drugs paid for by the study. The two groups will be compared on how well they follow their prescriptions, how their health changes, and what costs are incurred to the healthcare system through hospitalizations and emergency room visits.
Findings from the study will be available mid-2017.
Persaud said his hope is that the study informs the political debate on medication affordability.
According to Persaud, Canada is one of the only countries with universal healthcare that does not cover prescription drugs.
“We have inadequate levels of coverage in Canada…the question is, where are we going to end up?”
The province has public programs to cover drug costs for certain vulnerable patients, but those programs still leave significant gaps, said Steve Barnes, director of policy at the Wellesley Institute urban health think tank.
The Ontario Drug Benefit Program covers seniors and people on social assistance or in long-term care homes, while the Trillium Drug Program helps people whose drug costs are exceptionally high compared to their income.
“There’s an underlying assumption that public programs are there to serve specific groups of people and … employers cover the rest,” said Barnes.
But over a third of Ontario workers have no employer health benefits at all, according to the Wellesley Institute.
It’s people in areas around St. Michael’s and Ryerson University – in Moss Park and the less affluent parts of Cabbagetown – who are likely making too much money to qualify for assistance — yet not enough to afford medication.
Persaud said people in the service industry or cab drivers, for example, are liable to fall through the cracks.
By contrast, said Barnes, the government in his native New Zealand buys medication in bulk at a negotiated low rate, then sells it to patients for next to nothing.
“When you go to the drugstore you pay five dollars, which can be waived for people on low income,” said Barnes.
In January, Canadian Health Minister Jane Philpott announced the formation of a drug accessibility working group that would include federal, provincial and territorial health departments.
“We’ll be looking at a range of options from making drugs more affordable,” Philpott said in a news conference Jan. 21.
Philpott also agreed to join the provinces’ and territories’ pan-Canadian Pharmaceutical Alliance, which negotiates lower drug prices for public plans. According to Ontario Health Minister Eric Hoskins, the alliance already saves its members about half a billion dollars per year on public drug costs.
Changes are coming to Canada’s pharmacare, said Barnes, though it’s still not clear what those changes will be.
“We have inadequate levels of coverage in Canada,” he said. “The question is, where are we going to end up?”
Canada’s drug coverage has established a system in which the highest earners are the least likely to have out-of-pocket prescription expenses:
- 42 per cent of Canada’s prescription drug expenses are covered by government*
- 36 per cent of drug costs are covered by employer plans, which involve deductibles and co-payments*
- 22 per cent of Canadians’ drug costs are paid out of pocket*
- 93 per cent of Canadians making more than $100,000 per year have employer-provided drug coverage**
- 30 per cent of Canadians making between $10,000 and $20,000 have employer-provided drug coverage**
*According to “The Future of Drug Coverage in Canada,” report, published by the University of British Columbia, 2015.
**According to “Low Wages, No Benefits,” report published by the Wellesley Institute, 2015