Advanced Search
MyIDEAS: Login

Variance in Pharmacare Coverage Across Canada

Contents:

Author Info

  • Donald Willison

    ()
    (Department of Clinical Epidemiology & Biostatistics, McMaster University, Centre for the Evaluation of Medicines, St. Joseph's Hospital, Hamilton)

  • Paul Grootendorst

    (Department of Clinical Epidemiology & Biostatistics, Centre for Health Economics and Policy Analysis, McMaster University, Centre for the Evaluation of Medicines, St. Joseph's Hospital, Hamilton)

  • Jeremiah Hurley

    ()
    (Department of Clinical Epidemiology & Biostatistics, McMaster University, Centre for the Evaluation of Medicines, St. Joseph's Hospital, Hamilton)

Abstract

In 1997, the Canadian National Forum on Health recommended creation of a national pharmacare program, the key elements of which would include: (a) universal first-dollar coverage for medically necessary medications; (b) comprehensive information support tools for managers, clinicians, and consumers to guide in the optimal use of pharmaceuticals; (c) integration with primary care reform; and (d) innovative methods for management of costs. This recommendation has generated considerable controversy, position papers by various system stakeholders, and a national conference to debate alternative approaches to pharmacare. In an attempt to clarify some of the confusion in the context of the ongoing debate, we describe the nature of existing public prescription drug insurance coverage, and review what is known about private coverage in Canada. We focus, in particular, on provincial prescription drug plans, documenting the extent of variation in coverage across the provinces, and trends in this coverage in recent years. In addition, we have assessed the impact of the various cost-sharing provisions on a typical senior residing in the different provinces, using a series of simulations to calculate what the out-of-pocket costs would have been for a high- or low-income senior in each province under alternative scenarios regarding prescription drug consumption and the senior’s income. The elderly are among the most consistently covered groups within society. Although all provincial drug benefit programs have some coverage for seniors, there is substantial variation in the amount of coverage. This study reveals a substantial burden of out-of-pocket costs associated with an average drug consumption pattern. In addition, among seniors of similar income, we see up to a ten-fold variation in out-of-pocket payments for the same drug consumption among the provinces. In most provinces, the trend in the last decade has been toward greater cost-sharing. This reverses the trend observed between the 1960’s and 1990. With the exception of Quebec, which recently introduced a universal system of coverage (accompanied by significant increases in cost-sharing for those previously covered), recent extensions of coverage have tended to be piecemeal, to individuals with specific diseases or requiring specific drugs. As a consequence of the last thirty years of pharmacare policy, the availability of prescription drug insurance depends more on such factors as employment status and the type of employment, province of residence, age, and income than it does on underlying need for such therapy.

Download Info

If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
File URL: http://www.chepa.org/Files/Working%20Papers/98-08.pdf
File Function: First version, 1998
Download Restriction: no

Bibliographic Info

Paper provided by Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada in its series Centre for Health Economics and Policy Analysis Working Paper Series with number 1998-08.

as in new window
Length: 27 pages
Date of creation: 1998
Date of revision:
Handle: RePEc:hpa:wpaper:199808

Contact details of provider:
Postal: CRL Building, 282, 1280 Main Street West, Hamilton, Ontario L8S 4K1
Phone: (905) 525-9140, extension 22122
Fax: (905) 546-5211
Email:
Web page: http://www.chepa.org/
More information through EDIRC

Related research

Keywords:

References

No references listed on IDEAS
You can help add them by filling out this form.

Citations

Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
as in new window

Cited by:
  1. Deborah A. Freund & Don Willison & Grant D. Reeher & Bernie O'Brien & Jarold Cosby & Amy Ferraro, 2000. "Pharmaceuticals and the Elderly: A Comparative Analysis," Center for Policy Research Working Papers 17, Center for Policy Research, Maxwell School, Syracuse University.

Lists

This item is not listed on Wikipedia, on a reading list or among the top items on IDEAS.

Statistics

Access and download statistics

Corrections

When requesting a correction, please mention this item's handle: RePEc:hpa:wpaper:199808. See general information about how to correct material in RePEc.

For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Lyn Sauberli).

If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

If references are entirely missing, you can add them using this form.

If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.

If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.

Please note that corrections may take a couple of weeks to filter through the various RePEc services.