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Beneficiary Cost Sharing Under Canadian Provincial Prescription Drug Benefit Programs: History and Assessment

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  • P Grootendorst

Abstract

Federal legislation outlined in the Medical Care Act of 1965 and the Canada Health Act of 1984 stipulates that Canadian provincial governments are to administer insurance programs for medically necessary services provided by hospitals and physicians. The legislation did not mandate provincial government coverage for prescription drugs taken outside of the hospital. Each province has, however, provided coverage to seniors and social assistance recipients; some have introduced drug coverage for the general public. This paper reviews the history of the provincial drug insurance programs for these 3 beneficiary groups, from the inception dates of the programs to August 31, 1999. Attention is given to the terms and conditions for coverage, including eligibility conditions and amounts of beneficiary cost sharing. Review of the history of the provincial drug programs reveals significant variation in the amounts of patient cost sharing between and within programs and over time. In addition, there is a trend in most provinces to increase the generosity of coverage for those with large drug expenses relative to income, irrespective of beneficiary age. Some implications of these findings for proposals to extend public prescription drug coverage are drawn.

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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 1999-10.

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Date of creation: 1999
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Handle: RePEc:hpa:wpaper:199910

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Cited by:
  1. Thomas F. Crossley & Paul Grootendorst & Sule Kokkmaz & Michael R. Veall, 2000. "The Effects of Drug Subsidies on Out-of-Poket Prescription Drug Expenditures by seniors: regional Evidence from Canada," CEPR Discussion Papers 422, Centre for Economic Policy Research, Research School of Economics, Australian National University.
  2. Sule Alan & Thomas F. Crossley & Paul Grootendorst & Michael R. Veall, 2002. "Out-of-Pocket Prescription Drug Expenditures and Public Prescription Drug Programs," Quantitative Studies in Economics and Population Research Reports 379, McMaster University.
  3. Thomas F. Crossley & Paul V. Grootendorst & Michael R. Veall, 2003. "National Catastrophic Drug Insurance Revisited: Who Would Benefit from Senator Kirby's Recommendations?," Quantitative Studies in Economics and Population Research Reports 385, McMaster University.
  4. Hai Zhong, 2007. "Equity in Pharmaceutical Utilization in Ontario: A Cross Section and Over Time Analysis," University of Western Ontario, Economic Policy Research Institute Working Papers 20071, University of Western Ontario, Economic Policy Research Institute.
  5. William H. Crown & Ernst R. Berndt & Onur Baser & Stan N. Finkelstein & Whitney P. Witt, 2003. "Benefit Plan Design and Prescription Drug Utilization Among Asthmatics: Do Patient Copayments Matter?," NBER Working Papers 10062, National Bureau of Economic Research, Inc.
  6. Paul V. Grootendorst & Mitchell Levine, 2002. "Do Drug Plans Matter? Effects of Drug Plan Eligibility on Drug Use Among the Elderly, Social Assistance Recipients and the General Population," Social and Economic Dimensions of an Aging Population Research Papers 73, McMaster University.

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