July 19, 2013
Three years ago, Kevin Connell faced an impossible choice: buy the drugs to treat his cancer and put his family on the street, or die.
“Where was I going to get $10,000 a month?” asked the 62-year-old Fredericton man. “One year is $120,000. We would be into $400,000 by now and that is cash.”
Connell’s doctor prescribed him lenolidamide to treat his multiple myeloma, but the drug wasn’t covered by his private insurance and the province wouldn’t foot the bill until he turned 65.
“As if cancer knows what age to attack at,” Connell said. “To deny people basic treatment is to me something that is unfathomable.”
Connell is not alone. Thousands of Canadians are forced to make choices between their wallets and their well-being after a doctor hands them a prescription.
But creating a national pharmacare program could cover the costs of prescriptions for people like Connell and still manage to save money or break even, according to a recently-released report.
“If you provide people basically free drugs with medicines we know are good value for money for the health care system, it pays for itself in terms of the burden on the doctor’s offices and hospitals because people don’t come back,” said Steve Morgan at the University of B.C.’s School of Population and Public Health.
Morgan co-authored the C.D. Howe Institute report entitled “Rethinking Pharmacare in Canada” – a report that adds to the growing number of voices calling on governments to expand public coverage.
A patchwork approach to pharmacare
Canada is the only developed country with universal health care that doesn’t include prescription drugs in its coverage. Just 44 per cent of total drug expenditures are covered by provincial governments.
Canadians instead rely on a patchwork of provincial plans, private insurance and their pocketbooks to pay for prescription drugs.
Replacing the patchwork with a universal system could save governments up to $14 billion a year, according to Morgan.
Those savings would come from the increased purchasing power of a single public buyer and healthier patients.
“Every doctor and almost every clinic you go to will have a story of a patient who they’ve prescribed medication for but because they don’t have coverage, they are not able to pay for it,” said Dr. Danyaal Raza. “It’s frustrating.”
Raza works at a community health clinic in one of Ottawa’s poorer neighbourhoods and says a patient can go to the hospital and get everything covered, but the minute they walk out, medications are no longer paid for.
“An ounce of prevention is worth a pound of cure and it’s the same with medications,” Raza said. “When they are discharged from hospital with a prescription and they can’t fill it, that’s going to put them at a higher risk for going right back.”
It’s not just low-income Canadians facing the problem of high prescription costs. Allergies can mean huge bills for families. Crohn’s disease has left people struggling to make ends meet. Young adults with cystic fibrosis face costs in the thousands of dollars each month.
And of course there are retirees like Connell who have been cut off from workplace insurance and may not qualify for public plans due to age or income.
For Connell, the solution came when the company that makes the drug he needs provided it for free. The corporate welfare has allowed Connell to attend his daughter’s wedding, meet his first grandson and see his son graduate from university.
“I really feel that as a taxpayer and as a member of society that we shouldn’t be dependent on the goodwill of a corporation, that we as citizens can expect more from our governments to have a comprehensive plan that we can go to and be taken care of,” he said.
Bleak prognosis for change in Canada
But when it comes to national pharmacare reform, things can be complex in Canada.
The provinces are responsible for delivering health care, while the federal government helps in setting standards and paying the bills.
A universal pharmacare plan would mean getting an agreement between Ottawa as well as ten provinces and three territories.
It’s a discussion that has been had in the past, but didn’t result in consensus, according to Perry Martin, who is a representative on the Council of the Federation’s health care innovation working group. The council represents the country’s provinces and territories.
“Rather than getting stuck, I think the decision was made by premiers to focus on where we could really achieve on a pan-Canadian basis and that led us to the pricing side,” Martin said.
The provinces are focusing on lowering the cost of drugs by bulk-buying generics and negotiating prices for brand-name drugs collaboratively.
“If we can get our drugs cheaper, it lowers the cost for everyone,” Martin said, adding that he wouldn’t rule out a conversation about universal pharmacare at Council of the Federation meeting next week.
For now Ottawa appears content to let the provinces take the lead – and to leave pharmacare improvements to the way drugs are purchased by government.
“We are interested in working with the provinces and territories on bulk buying to potentially save even more on the costs of medications,” said newly-minted Health Minister Rona Ambrose in a statement.
But NDP MP Megan Leslie said Ottawa needs to step up and take leadership to get a universal pharmacare program off the ground.
“They don’t want to be leaders on this file and as a result we are paying the cost,” Leslie said. “We are paying the price directly, whether it comes to health outcomes or the cost we are paying at the counter.”
Looking to the private sector for answers
Others believe the answer lies outside of government.
The Fraser Institute — a right-leaning think tank – would rather see governments encourage a more competitive private-sector insurance market, with subsidies for those who need it.
It’s an approach preferred by the Canadian Taxpayer Federation, an organization that fears a big government program would lead to big waste.
“Experience generally proves when governments try to operate anything, it costs them a lot to do that,” said CTF director Gregory Thomas.
Thomas added projects managed by the federal government such as the procurement of fighter jets and submarines have been plagued by delays and questions about price.
“If the federal government took over prescription drugs, I think everyone would die eventually,” Thomas said.
But back in Fredericton, Connell believes people will die if the provincial and federal governments fail to act.
“It is a form of passive euthanasia that is happening in our society whereby our governments and our insurance people are failing to cover us…and we are falling through the crack now,” he said.
Read the article online here: http://globalnews.ca/news/728977/paying-for-more-drugs-will-cut-health-care-costs-for-governments-report/
To watch the related video: http://globalnews.ca/video/730177/man-with-cancer-cant-afford-drugs
- Rx: National Pharmacare - July 2013...Presented as part of a First Aid Kit for Canadian Health Care at the Council of the Federation July 2013. As physicians, we confront the daily challenge of see...
- CDM releases video: Why doctors care about Pharmac...August 7, 2013 VIDEO: Why doctors care about Pharmacare TORONTO – Doctors are adding their voices to the growing call for a national Pharmacare program with t...
- OP-ED: Cheaper drugs an integral part of health re...April 13, 2012 The StarPheonix Dr. Ryan Meili Meili is a doctor in Saskatoon and vice-chair for the group, Canadian Doctors for Medicare. Glen is a patient ...
- CTV: Dr. Dan Raza on the importance of a federal r...July 24, 2013 Watch CDM board member, Dr. Danyaal Raza speak about the importance of a federal role in health care. http://www.ctvnews.ca/video?binId=1.810415...
- One in 10 Canadians cannot afford prescription med...January 16, 2012 CTVNews.ca Angela Mulholland One in 10 Canadians have problems affording their prescription medication, often because they don't have insura...
- Many struggle to pay for prescriptions ...January 16, 2012 Globe and Mail Andre Picard On in four Canadians who do not have drug insurance are unable to afford to take their prescription drugs as dir...
- Better home care and better pay for doctors urged ...May 2, 2011 CMAJ Even on a cold winter night, it seems Canadians can’t resist the promise of an earnest evening of debate over medicare reform: With 500 peo...
- The many faces of transformation...August 24, 2010 CMAJ The contrast is nothing short of startling. For years, annual general meetings of the Canadian Medical Association (CMA) were primarily ...
- OP-ED: CMA’s welcome, if belated, change of heart ...August 6, 2010 The Toronto Star Every summer, before its annual meeting, the Canadian Medical Association (CMA) publicizes its recommendations for Canada's he...
- Quebec ranks second best in wait times ...December 4, 2012 Montreal Gazette Charlie Fidelman MONTREAL — Surgical wait times have fallen slightly, but Canadian patients continue to wait too long — a...
- Should we pay for blood? ...April 15, 2013 Maclean's By: Anne Kingston On March 11, federal Health Minister Leona Aglukkaq took to Twitter to issue her first public response to media re...
- Scaling Up: Danielle Martin at TEDxStouffville...July 20, 2013 Watch Danielle's TEDx talk here: http://www.youtube.com/watch?v=xa4PNZlmQSo&feature=youtu.be It has been said that the Canadian health care ...
- Doctors urge Health Care Action Plan to thwart ‘lo...February 28, 2011 Globe and Mail Gloria Galloway and Lisa Priest Doctors say federal leadership is needed to avert a looming health-care crisis and that bett...
- 2012 CDM Year in Review ...Click here to read our 2012 Year in Review. ...
- More or less Medicine: Danielle on the Agenda Feb ...February 5, 2013 Dr. Danielle Martin appeared as a panelist on The Agenda with Steve Paikin to contriubte to a discussion on the treatment of patients and whet...
- Make Shift Happen: Mobilizing the Power of the Pub...On April 20, 2012, Danielle Martin spoke at Public Interest Alberta's Conference Make Shift Happen: Mobilizing the Power of the Public. Click on the link below ...
- Don't allow for-profit blood clinics, say doctors...March 12, 2013 TORONTO - A controversial and secretive new move by the federal government to approve for-profit blood plasma donation services that pays donors...
- Top 10 Best Ideas to Transform Health Care...Improving the quality and efficiency of health care matters to all Canadians. Finding better and less expensive ways of providing care and preventing illne...
- Blood plasma clinics a sign of privatization in he...March 13, 2013 Toronto Star By: Theresa Boyle A group of doctors concerned about increasing privatization in Canada’s health-care system has added its voice ...