Canada is expected to dole out $253.5 billion in total health spending in 2018, or about $6,839 per Canadian, according to a Canadian Institute for Health Information report.

It’s a 4.2 per cent increase over last year, and adds up to almost 11.3 per cent of our gross domestic product, says the not-for-profit organization that studies national health care data.

Increases in health spending are typically tied to economic growth, said Jordan Hunt, the organization’s manager of pharmaceutical information.

“Health spending grows when the economy grows and might shrink when the economy shrinks,” Hunt said in an interview Monday. “Over the past decade — it has been stable, in terms of its share of GDP.

“We did see a bit higher public health spending per person in urban areas versus those living in rural areas — a little less than $200 per person,” he said. “It’s the first time it was something we looked at, at a high level.”

As the conversation about federal pharmacare gathers steam, the study indicates that Canada’s drug spending growth outstripped increases linked to hospitals and physician services.

Roughly $33.7 billion is expected to be spent on prescribed drugs this year, marking a 4.2 per cent annual increase in that category, compared with 4 per cent and 3.1 per cent for hospitals and doctors, respectively.

Hospitals continue to eat up the lion’s share ($1,933 per person) of 2018 spending, representing 28.3 per cent of total expenditures, while physician services accounted for 15.1 per cent.

The $33.7 billion in drug costs constitutes 15.1 per cent of the overall pie; with the remaining 41 per cent dedicated to a variety of health-care goods and services.

CIHI, which has been tracking health spending for 40 years, noted three classes of drugs fuelling this year’s spike in prescribed drug cost; with medications for rheumatoid arthritis and Crohn’s disease accounting for the highest proportion of drug spending (8.2 per cent) for the sixth consecutive year and antiviral treatments for hepatitis C coming at a close second, accounting for 5 per cent.

“There were two new drugs that came in 2016, that covered a wider range of the viral-types of hepatitis C, so people that maybe weren’t able to be treated with the older drugs a couple years ago are now able to be treated,” Hunt said.

Ontario’s former health minister, Dr. Eric Hoskins, now tasked with chairing a national pharmacare advisory council, scanned the CIHI report Monday, saying the prescribed drug figures mirrored some of those being generated in his committee’s ongoing survey of the country.

“It reinforces the importance to develop a blueprint for national pharmacare,” Hoskins said. “We’re paying too much. We’re third-highest in the world, in terms of per capita expenditure.”

“It will give us bulk purchasing power — if we’re all coming together as a unit,” Hoskins said touting the push for national pharmacare.

Challenges of affordability are being laid bare, Hoskins said, as upwards of three million Canadians queried in the advisory groups data finding mission, “said they had not filled one of four prescriptions in the last year because they couldn’t afford it.”

The council’s federal report on pharmacare is due by spring of next year.

In 2018, the public sector will shoulder $14.4 billion (42.7 per cent) of prescribed drug spending.

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“That’s gone down a lot,” said Don Drummond is the Stauffer-Dunning Fellow in Global Public Policy and adjunct professor at the School of Policy Studies at Queen’s University of the public-supported portion.

“We keep saying that we have a public health care system and less than 50 per cent of the pharmaceuticals are covered by the public domain,” Drummond said. “It definitely strengthens the case for national pharmacare as the public share keeps going down.”