Conference Board report reveals inequities in drug access, affordability for people with arthritis
Patients must be at the table when creating a national pharmacare program
TORONTO – Canadians face serious inequities in access and affordability to prescription medications depending on where they live and their access to employer-funded drug programs, says a report released today by The Conference Board of Canada. The report was funded by the Arthritis Society.
The findings show that public coverage of arthritis medications varies widely from province to province and presents different access hurdles depending on where you live. Public plans also lag behind private plans in providing timely access to new and innovative arthritis medications, as well as access to some anti-inflammatory drugs, analgesics, corticosteroids and anti-rheumatic drugs.
The report found that Canadians spent $1.9 billion on 16.5 million claims for arthritis drugs in 2017. Of all arthritis drugs, 22 per cent are paid for out-of-pocket, representing $248.9 million in uninsured spending.
“This is an urgent wake-up call for policy makers as we explore a national pharmacare program,” says Dr. Sian Bevan, Chief Science Officer at the Arthritis Society. “These findings lay bare the challenges facing arthritis patients in a way that leaves no room for ambiguity. Too many Canadians do not have equitable, affordable access to the treatments they need, and that has a serious impact on their health – and on Canada as a whole.”
Many of the six million Canadians living with arthritis rely on a range of medications over a number of years, in some cases for the rest of their lives. That’s why the Arthritis Society has been vocal in calling for the implementation of a national pharmacare program.
“No matter who is paying – government, employer or patient – the costs of medication for chronic disease management can quickly add up,” says Bevan, “which makes it critically important that equitable and sustainable solutions be found that ensure people receive the care they need today, and into the future as new and better therapies become available.”
One of those treatment innovations is biologic medications, which have revolutionized treatment and management of autoimmune diseases such as rheumatoid arthritis. They are also the most expensive drugs covered by many plans, both public and private, which makes their significance for arthritis management an expensive proposition for Canada’s health system. According to the Canadian Institute of Health Information, biologics represent the largest share of overall drug expenditures in Canada – a share that continues to grow. The Conference Board report calculates that $1.1 billion of Canada’s $2.7 billion in total biologics spending in 2017 was specifically for arthritis management.
We believe a national pharmacare program should:
- Address existing inequities: Too many Canadians are uninsured or underinsured, forcing them to make difficult choices about medication versus other expenses. Others may be covered or not depending on their province of residence, a kind of “postal code lottery” where your health outcomes can vary dramatically based on where you live.
A national pharmacare program should first address these inequities – not by pursuing a lower standard of coverage, but rather by increasing affordable coverage for those who need it most, and by removing obstacles to accessing that coverage.
- Ensure access to a range of therapies: A national pharmacare program should provide timely access to a range of treatments – what works for one patient may not work for another – and ensure that patients are not hindered by an overly restrictive formulary or a system that is slow to recognize the value of new therapies like biologics. As many of these new treatments become increasingly more precise and better able to target patients who will most likely benefit from them, it will not only lead to improved health outcomes, but also health system savings in the long run.
- Consider expanding out-of-hospital care: Improving the affordability of medicines is an important objective, but if we want to truly make a lasting impact on our health system, we need to start thinking about the national pharmacare debate as a broader and more ambitious opportunity to modernize the basket of publicly funded services and improve out-of-hospital care more generally. This includes improving access to home and community-based care and focused efforts on prevention to avoid the onset of many chronic conditions.
The recommendations found in the Final Report of the Advisory Council on the Implementation of National Pharmacare, led by Dr. Eric Hoskins, address some but not all of these considerations. That makes it vital that any effort to move forward on national pharmacare must be informed and advised by strong patient participation focused on addressing urgent patient needs.
About the Arthritis Society
The Arthritis Society is Canada’s national charity dedicated to creating a world where people are free from the devastating effects of arthritis. The passion to alleviate suffering that inspired our founders in 1948 continues to drive us today. Thanks to the trust and support of our donors and volunteers, the Arthritis Society is the largest charitable funder of cutting-edge arthritis research in Canada and a leader in proactive advocacy, innovative information and support that delivers better health outcomes for the people we serve. The Arthritis Society is accredited under Imagine Canada’s Standards Program. For more information, to make a donation or to volunteer, visit arthritis.ca.
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