Canada pays more for prescription drugs for common conditions than other wealthy countries: CMAJ study

Canada had the second-highest medication costs for common conditions such as high blood pressure and cholesterol in 2015 compared to nine other affluent countries with universal health-care systems, suggests a new study calling for a national drug plan to lower prices.

Lead author Steven Morgan, a professor at the University of British Columbia's Public School of Health, said the analysis looked at the volume and daily cost of drugs in Canada, the United Kingdom, Switzerland, Sweden, Norway, the Netherlands, France, Germany, New Zealand and Australia.

The study, which was published Monday in the Canadian Medical Association Journal, analyzed data involving medications to treat six conditions: high blood pressure; high cholesterol; depression; diabetes; pain; and gastrointestinal issues, such as ulcers.

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Annual expenditures per capita ranged from $23 in New Zealand to $171 in Switzerland. In Canada, the cost was $158.

Canada was the only country in the study that lacked universal coverage of outpatient prescription medications as part of its hospital and medical care.

"We have mixed financing, some public and some private, but we also have many people with no insurance," Morgan said.

"We end up spending more because, on average, we're using a more expensive mix of treatments available, which tend to be slightly more prone toward the newer patented drugs rather than the older, off-patented drugs," he added.

"This study shows that Canada is a relatively poor performer in terms of encouraging cost-conscious prescription drug utilization and a very poor performer in terms of achieving low prices for both the brand name and generic drugs that would be used for these therapeutic categories."

Morgan said the prices paid in Canada for generic drugs are among the highest in the world and lower volumes of purchases compared to other countries is oftentimes a factor.

High costs for primary-care drugs have major implications for patients, he noted.

"It's estimated that one in 10 Canadians can't fill their prescriptions or chooses not to fill their prescriptions as required because of the out-of-pocket costs associated with that."

Commentary calls for universal pharmacare

In a commentary on the study, Dr. Joel Lexchin of York University in Toronto said, "Canada needs universal pharmacare."

"Canada is not doing well when it comes to ensuring that its population has access to prescription medications," he said. "We can and must get to a better place."

• How prescription drug prices are set, why Canada's system is outdated

Last month, federal Health Minister Jane Philpott announced consultations on proposed regulatory changes related to a drug prices board to curb "unacceptably high" costs.

The Patented Medicine Prices Review Board was created in 1987 to establish a maximum price for new patented drugs and to limit increases to the rate of inflation until the patent expires. But Philpott said it is no longer fully able to protect Canadians from excessive prices.

The consultation period, which runs until June 28, includes meetings between Health Canada, patient groups, health professionals and the pharmaceutical industry.