Pharmacare could save over $1600/year per patient and promote ‘pharmoequity’  finds study

Posted on June 1, 2023 in Health Policy Context

Source: — Authors: – Analysis
May 31, 2023.   By Steven Staples

Canadians are waiting for a long-promised universal, single-payer, public system of prescription drug coverage in Canada, and now a new study says the delay of pharmacare has cost the health care system in missed savings.

Providing free medicine to patients reduces costs to the health care system and contributes to overall health equity, researchers learned.

Question What is the effect of eliminating out-of-pocket medication costs on total health care costs?
Findings In this secondary analysis of a randomized clinical trial of 786 primary care patients in Ontario, Canada, eliminating out-of-pocket medication costs was associated with lower reduced total health spending by a median of $1641 and a mean of $4465 over 3 years.
Meaning These findings suggest that eliminating out-of-pocket medication costs for patients could reduce overall costs of health care.

The study published in the journal JAMA Health Forum tracked a total of 747 patients in Ontario who reported that in the year preceding the study they had not filled a prescription, or had not taken medicine as instructed to make a prescription last longer due to the cost.

All the patients were provided usual access to health care services, but half were provided their prescription medicines for free.

The researchers were surprised at the dramatic results. Providing prescriptions free-of-charge to some patients saved the public health-care system a median $1,641 per patient per year by helping to prevent such things as unexpected trips to the hospital.

The study’s authors wrote, “free medicine distribution may help achieve the quintuple aim that includes both reducing health care spending and improving health equity or fairness in health care and outcomes by ensuring that financial means are not a barrier to realizing the benefits of medicines.”

They noted that the research supports recent calls for “pharmacoequity,” or access to high-quality medicines, “regardless of race and ethnicity, socioeconomic status, or availability of resources.”

“I was surprised by the magnitude of the savings,” Dr. Nav Persaud of St. Michael’s Hospital in Toronto, one of the study’s authors, told CBC.  “It seems like eliminating medication costs both saves money in avoided hospitalizations, avoided emergency room visits, makes people healthier and addresses health inequities — it makes access to health more fair.”

The report supports recent calls for “pharmacoequity,” or access to high-quality medicines, “regardless of race and ethnicity, socioeconomic status, or availability of resources.”

The study’s positive findings should encourage Ottawa to move forward on the Canada Pharmacare Act as soon as possible, a commitment made by Prime Minister Trudeau to NDP leader Jagmeet Singh last year in return for the NDP’s support of the Liberal minority government.

Health Canada officials are reportedly preparing options for the new legislation as the clock ticks down to pass the Act before the end of 2023.

The Canadian Health Coalition’s volunteers met with over 60 Parliamentarians in March to demand a public universal pharmacare program, as described by the government’s own Advisory Council on the Implementation of National Pharmacare, led by former Ontario Health Minister Dr. Eric Hoskins.

The so-called Hoskins Report, released in 2019 after extensive consultations, recommended, “the federal government work with provincial and territorial governments to establish a universal, single-payer, public system of prescription drug coverage in Canada.”

According to Dr. Hoskins’ plan, national pharmacare would have started offering universal coverage for a list of essential medicines on January 1, 2022. This suggests the delay has cost the health care system, and the health of many Canadians, very dearly.

Steven Staples is the National Director of Policy and Advocacy for the Canadian Health Coalition

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