One feature of the new United States-Mexico-Canada Agreement is an extension of patent protections from eight to ten years for a class of pharmaceuticals known as biological drugs. The NDP and others have criticized this aspect of the agreement, claiming it will increase the price of drugs in Canada.

In October, Don Davies, NDP health critic and MP for Vancouver Kingsway, pointed to the already-high cost of prescription drugs. During question period, he said, “one in four Canadians skips necessary medicine because of cost.”

For this check, we’ll set aside the impacts of the trade deal, the USMCA, and focus on Davies’ claim that one in four Canadians forego prescription drugs due to their cost.

Where does Davies’ claim come from?

Davies told us the source of his claim is a 2015 report from the Angus Reid Institute. The report presents the results of an online survey on prescription drug affordability and public support for universal pharmacare.

According to the survey results, 23 per cent of Canadians reported that they or someone in their household didn’t take their medicine as prescribed, if at all, because of cost in the past twelve months. This figure includes those who didn’t fill a prescription, didn’t renew a prescription, and/or did things to make a prescription last longer such as skip or reduce dosage due to cost.

Davies’ claim exaggerates the results of the Angus Reid survey. He attributed the 23 per cent to individuals, rather than households.

The survey asked respondents whether they or someone in their household decided not to fill or renew a prescription, or did something to make their prescription last longer, due to cost. As the Angus Reid report points out, we would expect household figures to be larger than those of individual Canadians.

Ian Holliday, research associate for Angus Reid, said, “because of the ‘you/anyone in your household’ construction, our 2015 report avoids describing this finding as ‘one-in-four Canadians do at least one of these things,’ and instead constructs it as ‘one-in-four Canadian households’ or ‘one-in-four Canadians say they or someone else in their household do at least one of these things.’”

Davies’ misrepresentation of the survey findings exaggerates the scope of the issue. Consider that 23 per cent of the total Canadian population is roughly 8.5 million people. But 23 per cent of Canadian households reporting that someone in the family skipped their medication might only tally 3.5 million individuals (the average Canadian household size is 2.4 people). This is a very rough extrapolation of the survey data, but it shows how Davies’ claim inflates the survey findings.

What have other studies shown?

A 2018 study led by Michael Law, a professor at UBC’s School of Population and Public Health, examined the number of individual Canadians who can’t afford prescription drugs. The researchers found that 5.5 per cent of Canadians skipped or reduced dosages, delayed refilling prescriptions, or didn’t fill prescriptions at all due to cost. Law’s study is based on voluntary survey data from the Statistics Canada Canadian Community Health Survey.

So, not only does Davies’ ‘one in four Canadians’ figure exaggerate the data he’s cited, there is also more recent, academic work that looks at individual rather than household rates. Law’s findings put the number of Canadians who skip prescription medications closer to one in twenty.

Without delving too deep into the methodologies of both studies, we would note that Law’s study used a much larger sample size than the Angus Reid study. The Canadian Community Health Survey data, which Law’s report is based on, included responses from 28,091 Canadians aged 12 and over. By contrast, the Angus Reid data was limited to responses by 1,556 Canadian adults who are members of the Angus Reid Forum.

Verdict

Davies’ claim that one in four Canadians skips necessary medication because of cost is false because it misrepresents the data he cited and exaggerates the scope of the issue. The figure he quoted comes from a survey that found one in four Canadian households did not take medication as prescribed, if at all, due to cost. That survey did not look at the number of individual Canadians who can’t afford medication. Additionally, an academic study published in 2018 did look into individual experiences, and found that 5.5 per cent of Canadians or 1 in 20 skipped or didn’t take their medication as prescribed because they couldn’t afford it.

Beyond the national average

It’s informative to know how many Canadians, overall, face cost-related barriers to accessing prescription medication. However, the national average doesn’t tell us everything. Different regions and groups are more likely than others to face these barriers. Both Law’s study and the Angus Reid report also examine subsets of the Canadian population.

The Angus Reid study looked at rates across Canadian provinces. According to their survey data, British Columbia and Atlantic Canada have the highest rates of access barriers, with 29 and 26 per cent of households, respectively, failing to take medicines as prescribed, if at all. Law’s study also found the highest rates in British Columbia.

Law’s study also found several characteristics associated with higher odds of his reporting having skipped medication or taken measures to make medication last longer due to cost. Those more likely to report these experiences are women, 18-44 year-olds, those with poorer health status, lower-income individuals, and people who don’t have prescription drug insurance. Indigenous Peoples were nearly twice as likely to report the same challenges.

Additionally, Law’s study found that drugs for mental health conditions were the most commonly reported drug class that patients skipped or didn’t take as prescribed because of cost.