Publicly funding drugs for all Canadians could save over $4 billion a year

Universal public coverage of 117 essential medicines could address the needs of most Canadians for pharmaceutical drugs, and possibly save more than $4 billion a year, according to a new study published in the Canadian Medical Association Journal, CMAJ.

An essential medicines list could improve care, doctors say. Jacques Boissinot, Canadian Press

University of British Columbia, EurekAlert! February 27, 2017

“Adding an essential medicines list is a pragmatic step toward universal pharmacare,” states Steven Morgan, a professor in the School of Population and Public Health at the University of British Columbia (UBC). “It would ensure all Canadians have access to the most commonly required medicines while saving patients and private drug plan sponsors over $4 billion per year.”

The researchers identified a list of 117 essential medicines that accounted for 44% of all prescriptions filled at retail pharmacies in 2015 and up to 77% of all prescriptions when therapeutically similar medications were included. These medicines included antibiotics, insulin, heart medication, antidepressants, oral contraceptives and more.

“Universal pharmacare has been long-promised but undelivered in Canada, in part because of concerns about where to start,” said Morgan. “We show that adding universal public coverage of essential medicines to the existing system of drug coverage in Canada is a significant and feasible step in the right direction.”

In a related study published concurrently in CMAJ Open, researchers adapted the World Health Organization’s Model List of Essential Medicines, identifying 125 essential medications for Canada.

“The World Health Organization (WHO) says these essential medicines should be available to everyone who needs them,” said Dr. Nav Persaud, St. Michael’s Hospital, Toronto, who led the team that developed the essential medicines list and was a coauthor of the CMAJ paper. “We adapted the WHO’s list based on clinical practice in Canada.”

The authors of the CMAJ study note that it was a simulation study and thus based on assumptions around drug usage, prices, product substitutions and other factors.

Morgan and Persaud propose that governments purchase the essential medicines in bulk for all of Canada, which they found would save patients and private drug plans $4.3 billion per year while costing government an additional $1.2 billion per year.

“Commissions on the Canadian health care system have repeatedly concluded that universal, comprehensive public pharmacare is the most equitable and efficient means of achieving access to appropriate and affordable care for all Canadians,” the authors conclude.

Researchers from the University of British Columbia, Vancouver BC, St. Michael’s Hospital and the University of Toronto conducted the CMAJ study.

Source UBC via EurekAlert! AAAS

  References

cmaj-E295.full_
Estimated effects of adding universal public coverage of an to existing public drug plans in Canada, Steven G. Morgan PhD, Winny L, MSc, Brandon Yau BSc, Nav Persaud MD MSc. CMAJ 2017 February 27;189:E295-302. doi: 10.1503/cmaj.161082

  Further reading

cmajo-20160122
Development of a preliminary essential medicines list for Canada, Michael S. Taglione BSc, Haroon Ahmad BA MA, Morgan Slater PhD MSc, Babak Aliarzadeh MPH MD, Richard H. Glazier MD MPH, Andreas Laupacis MD MSc BA, Nav Persaud BA BSc MD MSc. CMAJO February 27, 2017 vol. 5 no. 1 E137-E143 doi: 10.9778/cmajo.20160122

The case for an essential medicines list for Canada, Eom G, Grootendorst P, Duffin J. CMAJ. 2016 Dec 6;188(17-18):E499-E503. Epub 2016 Jun 13.

Toward better prescription drug surveillance in Canada, Smolina K, Persaud N, Morgan SG. CMAJ. 2016 Aug 9;188(11):E252-3. doi: 10.1503/cmaj.151120. Epub 2016 May 2. CMAJ vol. 189 no. 8 doi: 10.1503/cmaj.161082

Canada can afford universal pharmacare — no more excuses, Matthew B. Stanbrook MD PhD, Deputy Editor. CMAJ April 21, 2015 vol. 187 no. 7 First published March 23, 2015, doi: 10.1503/cmaj.150281

Addressing cost-related barriers to prescription drug use in Canada, Karen L Tang MD, William A Ghali MD MPH, Braden J Manns MD MSc. CMAJ March 4, 2014 vol. 186 no. 4 First published September 16, 2013, doi: 10.1503/cmaj.121637

Also see
Universal public coverage of essential drugs would improve health care, research suggests CBC News
1 in 10 Canadians can’t afford prescriptions: the case for national pharmacare The Current, CBC Radio
What you need to know about a universal prescription drug plan Global News
Prescription drug expenses in Canada are a health-care barrier Science Daily
Universal public drug coverage would save Canada billions University of British Columbia
How an essential medicines list could benefit Canadians CBC News
High anxiety over drug costs in Chemical & Engineering News

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