One in ten Canadians cannot afford to take their prescription drugs as directed, according to an analysis by researchers from the University of British Columbia and the University of Toronto.

The study, published today in the CMAJ (Canadian Medical Association Journal) is the first to examine the relationship between drug insurance and the use of prescription drugs in Canada. Researchers from UBC's Centre for Health Services and Policy Research reviewed data from 5,732 people who answered Statistics Canada's Canadian Community Health Survey. They found that 9.6 per cent of Canadians who received a prescription reported not filling, failing to refill, or skipping doses for cost reasons. The phenomenon is particularly prevalent for Canadians who do not have drug insurance, with 26.5 per cent reporting not being able to afford their prescription drugs.

"Our results clearly demonstrate that cost-related problems in accessing prescription drugs are disproportionately borne by the poor, the sick and the uninsured," says Michael Law, Assistant Professor at UBC's School of Population and Public Health. "More than one in four Canadians without health insurance are forced, financially, to go without the prescription drugs they need."

Prescription drugs fall outside the Canada Health Act, resulting in a "patchwork" of drug coverage that leaves two-thirds of Canadian households paying all or part of their prescription drug costs. The Canadian Institute for Health Information estimated these out-of-pocket payments totaled $4.6 billion in 2010.

The results of the UBC study show that individuals without drug insurance are 4.5 times more likely to avoid taking prescribed medications because of cost. Similarly, Canadians with low incomes are 3.3 times more likely to not use prescription drugs because they cannot afford them.

The study also shows that Canadians who reported fair or poor health status did not take their prescribed medications 2.6 times more often than those who reported good or excellent health; similarly, those with chronic conditions were 1.6 times more likely to not take their medicines as directed due to cost.

Provincially, those living in British Columbia were more than twice as likely to report not being able to afford their prescription drugs than those living in other large provinces. This is a cause for concern, says Law.

"The Canadian most likely to have problems affording their prescription drugs is in poor health, carries no drug insurance, and lives in British Columbia," Law adds.

"As the Provincial Premiers meet in Victoria this week, they should consider expanding and improving public coverage for prescription drugs to reduce the influence of cost on whether or not Canadians can afford their prescription drugs."

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More information: Paper online: Paper online: www.cmaj.ca/lookup/doi/10.1503/cmaj.111270