Policy options: Towards making a universal prescription drug policy for Canada

A universal prescription drug coverage policy remains an unfinished business of Canadian healthcare system with over sixty year long historical roots. Since national medicare doesn't provide prescription drugs outside of hospitals, provinces and territories have independently developed public drug insurance programs (primarily for seniors and the poorest on social assistance) under various eligibility and patient cost-sharing arrangements. The absence of universal public coverage inevitably created a large role for private financing of prescription drugs by means of a variety of costly private insurance plans and out-of-pocket payments that many Canadians cannot afford. This situation has by now driven the system to a crisis point where the phenomenon of fast-rising costs of medically necessary drugs has added further adverse effects on public health, in terms of reduced equity of access and lost socio-economic wellbeing. It costs the health system billions of dollars downstream by requiring additional visits to physicians and resulting hospitalizations as patient health conditions deteriorate due to cost-related non-adherence to prescriptions. In the past a number of attempts towards making a national pharmacare failed and the status quo with a confusing patchwork prevailed. Of late, the federal government has taken a sincere initiative to implement a universal drug coverage plan inclusive of some measure of user-charge. This study evaluates the likely impact of different types of patient charges in a public system of prescription drug coverage for Canada. Employing qualitative and quantitative methods of analysis, it examines both primary and secondary data to evaluate the three policy options considered in this study. Taking all aspects into account, reasonable policy recommendations are made to make an affordable and efficient prescription drug coverage for all Canadians with the aim of reducing cost-related non-adherence to prescriptions, providing improved access to medications and, in the end, to achieve better health outcomes.