The Implications of catastrophic drug coverage on high-cost users of pharmaceuticals in British Columbia

Disparities in drug coverage exist across and within provinces and may worsen as costs increase. Because of their condition, such disparities make chronically ill patients vulnerable to large out-of-pocket costs. This study qualitatively investigates the lifestyle impacts of British Columbia’s Fair PharmaCare program upon persons with diabetes and cardiovascular disease, with household income between $30,000 and $50,000. Focus group discussions, telephone interviews, and participant questionnaires determine how income-based, catastrophic drug coverage serves, or does not serve, chronically ill, middle-earning members of the population. The hypothesis is that Fair PharmaCare creates financial strains that negatively affect the target group’s quality of life. My findings show that Fair PharmaCare creates financial pressures that influenced some participants to cut back on medications, make difficult trade-offs, and experience financial stress. Based upon my findings I recommend that the province improve public pharmaceutical coverage, and work towards integrating outpatient prescription drug benefits under Medicare.