In a recent post by the Cameron Institute, Dr. John A. Bachynsky suggests that “there are a growing number of gaps in coverage that calls for some form of universal, comprehensive, national drug coverage to fill these gaps” (Bachynsky 5). These ‘gaps,’ Bachynsky maintains, are caused by the provincial health ministries’ focus on price reduction while not considering the need for specific drugs; he opens the piece with an example wherein a drug priced at $600,000 for only two patients is considered ‘unaffordable’ while a ‘cheaper’ drug can have greater overall costs while being distributed to more patients. Instead, “Canadian government drug plans use the comparison with older, generic drugs ‘which do the same thing’ at a lower price” (4), as opposed to introducing more specific, improved drugs into the market. According to Bachynsky, the government does so by supporting multiple groups that restrict access to drugs and none that improve access, and labelling the prices of new drugs as ‘cost increases’ while there is no prior price to compare it to (3,4).
Naturally, blanket marketing drugs to a population with varied medical needs is problematic, especially for Canadians that are being medicated for long-term chronic illnesses. As Bachynsky points out, the problem with even reasonable drug prices is that they are utilized most often by only a segment of the population, but in high amounts. As Canadians have to pay for medical prescriptions out of pocket, with or without medical insurance, these ongoing costs can be financially draining; Bachynsky states that 25% of the chronically ill patients in Canada attempt to lower costs by stretching or skipping their medication (5), which is inadvisable even if they are using the ideal drug. The “universal, comprehensive, national […] coverage” that Bachynsky calls for is to aid this percentage (5), whom he suggests national assistance programs were initially created to protect.
While medication costs are legitimately high for the average Canadian citizen, they are not as troublesome for the government as provincial bodies would have you believe; Bachynsky cites drug expenditures as only 8% of government health care costs (6). Health care costs for the government have increased via the technological advancement and increase in litigation that comes with the unique and improved drugs the pharmaceutical industry is developing. While this is ‘too costly’ for the government, Bachynsky points out that “use of new technology has increased physician and hospital expense to an even greater degree but there is no outcry over excessive costs or sustainability” (7). The alternative treatments for a patient with no appropriate drugs for their condition utilize the latter technologies in a manner that is expensive, inefficient, and distressing for the patient, with measures such as hospital care, tests, referrals and surgeries. This realization begs the question: “why can we fund a lot of less effective procedures without complaint but not afford to pay for medication that does a better job and is preferred by the patient” (7).
The problem with reducing medication costs, while this would be to the benefit of both the government and the patient, is that pharmaceuticals are less likely to market drugs at a lower price point. Thus, the government’s solution to cut costs directly affects the patient; Bachynsky cites the example of “proposed therapeutic substitution” (10), in which the government will only cover the lowest-cost medical therapy for a variety of related illnesses. If a patient wants the more expensive treatment that is specific to their illness, they have to cover the cost.
As the burden of medication costs is something not experienced by the entire Canadian populace, the relationship between pharmaceuticals and government can go unconsidered by many in a nation that boasts free health care. Thanks to Doctor Bachynsky for writing an angle on that relationship! You can read the original post here.
Bachynsky, John A. “Opinion: Drug Prices are Too High!?” Cameron Institute. Cameron Institute (2016).