Nearly one-quarter of Canadians say they or someone in their home can't afford prescribed drugs and are splitting pills and skipping doses to make the medicine go further – or not renewing or even filling prescriptions, according to a new poll.

In addition, 36 per cent of the Canadians surveyed reported they have friends or family members who are having trouble paying their drug costs; Atlantic Canadians and British Columbians struggle the most. The Angus Reid Institute poll also found that one in five Canadians spend $500 or more a year on prescriptions – and nearly half of those surveyed are worried they won't be able to afford the drug costs 10 years from now.

It's no surprise that the survey – the first to take such a deep look at the affordability and accessibility of prescription drugs across the country – also found overwhelming support (91 per cent) for a national pharmacare program.

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The study, released Wednesday, comes as Canada's premiers are in St. John's for their annual summer conference, where they will discuss the issue, and as Canadians prepare for the federal election in the fall. The debate for a national pharmacare program has been going on for decades – Canada is the only country with a universal health-care system that doesn't cover prescription drug costs. But lately the idea has been gaining traction.

Last month, Ontario Health Minister Eric Hoskins and some of his provincial and territorial colleagues called for the idea of a national program to be a federal election issue.

The Angus Reid Institute, a non-partisan, not-for-profit polling organization, joined ranks with Vancouver-based Mindset Foundation, a Canadian charity that has been commissioning research on problems of accessing medicine for the last six years, to take a comprehensive look at the issue. Both organizations contributed equally in the project.

"I don't think anyone anticipated … that high number of people coming back and actually saying this is an [issue] for us," says Shachi Kurl, senior vice-president of the Angus Reid Institute. The institute, noted Ms. Kurl, is not pushing for a national program. The study, she said, is "an attempt to understand the real experiences of Canadians when it comes to drug costs."

Steve Morgan, director of the Centre for Health Services and Policy Research at the University of British Columbia, who helped analyze the data, called the results "striking."

"We have known in the past that approximately one in 10 Canadians doesn't fill their prescriptions … because of the cost of the prescription to the family," Dr. Morgan said, referring to a Statistics Canada study and one other from 2007, on which he was the senior author. "What we now know is this affects nearly one in four families in Canada."

The poll of 1,556 Canadians was conducted between July 2 and 6. It has a margin of error of plus or minus 2.5 percentage points, 19 times out of 20, the pollster says.

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Dr. Morgan noted there are regional differences in costs given the various drug schemes across the country. "But there is no province where you can say that there is nobody put at that kind of risk in Canada," he said. "We have a problem across all provinces in terms of access to medicines that are being prescribed. We are the only developed country with universal health care that basically ends as soon as the doctor hands the patient a prescription to fill."

More than 23 per cent of respondents said that in the last 12 months they or someone in their home did not "take their medicines as prescribed because of cost." Fourteen per cent said they did not fill a prescription; 10 per cent did not renew one, and 15 per cent said they cut pills or skipped doses.

The survey found that 29 per cent of British Columbians do not take their drugs because of costs. "This is possibly because government in B.C. offers only 'catastrophic' drug coverage and may also reflect the higher cost of living in this region," according to the report.

About 26 per cent of Atlantic Canadians face the same problem as on the West Coast – the report says it could be the result of the "limited nature of provincial drug plans" in the region.

Despite the support for a plan, there are some concerns: 51 per cent of respondents are worried that giving away prescription drugs for free will lead to abuse, including 66 per cent who voted for the Conservatives in the last election.

And how to pay for a national plan also troubles Canadians. In the survey, respondents rejected the notion it be financed through a hike in the GST or income tax. Rather, a hike in the corporate tax rate to its 2010 rate of 18 per cent is more palatable, with 52 per cent of respondents saying any potential program should be run jointly by the federal government and provinces.

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In a statement e-mailed to The Globe and Mail by her spokesperson, federal Health Minister Rona Ambrose wrote that "when it comes to the cost of prescription drugs, Canadians are being ripped off." However, for now, she supports "bulk drug purchasing" as the "most effective, common sense method to improve access to life-saving medications while ensuring value for all Canadians."