The Tyee has published my article Yet Another Case for Universal Pharmacare, based on the CMAJ study I posted about this morning. Excerpt:
Canadians may feel smug about 50 years of Medicare (especially compared to the Americans), but we're paying far more than we need to for prescription drugs -- and actually running up the cost of healthcare in the process.
A study published today in the Canadian Medical Association Journal argues that we are the lone exception among countries with universal health insurance in making some patients pay the costs of the drugs they need. Yet some kind of universal pharmacare system, the authors say, has been repeatedly recommended in Canada since the 1964 Royal Commission on Health Services.
Instead we have a patchwork of federal and provincial plans. "Federal drug plans cover First Nations and other targeted populations that account for two per cent of prescription costs in Canada," the study says, while various provincial plans cover some costs across the country. All told, 22 per cent of prescription drug costs "are funded out-of-pocket by patients."
Or by patients who can afford those costs, anyway. The authors say about one in 10 Canadians can't afford to buy their medication, compared to just one in 50 in Britain. For about one in 20 of us, prescription drugs cost over $1,000 in 2007. The predictable consequences: protracted illness, often resulting in treatment of ailments that are more serious and more costly.
In 2012-2013, the study says, Canadians spent $22.3 billion on retail prescription drugs; in B.C., we spent $2.28 billion. In order to measure the cost effectiveness of a universal public drug plan, the authors made some reasonable assumptions, including "small but tiered co-payments... exemptions for low-income families," but no change to pharmacists' dispensing fees and retail markups on prescriptions filled.
By adjusting various factors in their pricing models, they found a range of scenarios. Even the worst-case scenario, they found, would reduce national costs of prescription drugs to $18 billion -- a 19 per cent drop. Under the best case, costs would fall to $12.9 billion, or 42 per cent less than we spend now.