National pharmacare the wrong solution: think-tank

Advocates for national pharmacare have misdiagnosed the nature of gaps in prescription drug plan coverage in Canada and have proposed the wrong solution, according to a new study by think-tank the Canadian Health Policy Institute.

Based on Canada’s 2016 population of almost 36.3 million people, the study found close to 23.2 million had coverage through a private drug plan. The remaining 13.1 million had first- or second-payer coverage under public programs.

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“The problem isn’t uninsured people, it’s underinsured drug costs,” said Brett Skinner, founder and chief executive officer of the Canadian Health Policy Institute and author of the study, in a news release.

The study also showed that, among Canadians with coverage under public drug plans, nearly 840,000 were eligible for first-payer coverage under the federal non-insured health benefits program, which services First Nations and Inuit citizens. As well, nearly 8.2 million people were active claimants under first- or second-payer coverage in their provincial or territorial public drug plan. At the same time, close to 4.1 million people were eligible as inactive claimants for either first- or second-payer coverage under public plans, according to the study.

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Among inactive claimants, the study estimated that more than 2.4 million people in lower-income family groups faced potential exposure to income-adjusted deductibles, copayments or premiums between $0 and $2,000 per family. In addition, more than one million middle-income Canadians faced cost-sharing ranging between $2,000 and $5,000 per family. Furthermore, nearly 600,000 high-income earners faced potential costs of more than $5,000 per family.

The study also suggested that advocates for national pharmacare have misrepresented surveys of Canadians reporting cost-related reasons for not taking their prescribed medication to mean that many Canadians lack coverage under any prescription drug plan.

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“Those survey results are best explained by exposure to cost-sharing,” said Skinner.

“Simply forcing the entire population into a new national pharmacare plan is not a remedy for reducing under-insured drug costs. It is easier and less expensive to adjust the cost-sharing criteria for existing public drug plan benefits.”