Universal public coverage of essential medicines would improve access, save billions

Publicly funding essential medicines could cover the cost of nearly half of all prescriptions in Canada, removing financial barriers for Canadians while saving $3 billion per year.

The new research, led by Steve Morgan of the University of British Columbia and Dr. Nav Persaud of St. Michael’s Hospital in Toronto, was published today in the Canadian Medical Association Journal.

“Universal pharmacare has been long-promised but undelivered in Canada, in part because of concerns about where to start,” said Morgan, a professor in the school of population and public health. “We show that adding universal public coverage of essential medicines to the existing system of drug coverage in Canada is a significant and feasible step in the right direction.”

The researchers identified a list of 117 essential medicines that included antibiotics, insulin, heart medication, anti-depressants, oral contraceptives and more. They found that this list accounted for 44 per cent of all prescriptions written in 2015, and up to 77 per cent of all prescriptions when therapeutically similar medications were considered.

“The World Health Organization (WHO) says these essential medicines should be available to everyone who needs them,” said Dr. Persaud, a family physician who led the team that developed the essential medicines list. “We adapted the WHO’s list based on clinical practice in Canada.”

Currently, Canadians rely on a patchwork of private and public coverage that leaves millions facing high out-of-pocket costs for drugs. Recent research has shown that many Canadians do not take medications as prescribed because they cannot afford the out-of-pocket cost.

“Access to medicines can be the difference between life and death,” said Dr. Persaud. “There are treatments for HIV and heart disease that save lives but only when they are in the hands of people who need them.”

Morgan and Dr. Persaud propose that governments purchase the essential medicines in bulk for all of Canada, which they found would save patients and private drug plans $4.3 billion per year while costing government only an additional $1.2 billion per year. The total net savings for Canadians would be $3.1 billion per year.

“A program of this kind is a feasible way of improving the overall health of Canadians while dramatically lowering drug costs,” said Morgan. “Other countries that do similar things pay 40 to 80 per cent less for these essential medicines.”

Dr. Persaud is leading a clinical trial with patients in four Family Health Teams in Ontario to compare the health outcomes and health-care use of people who received the free essential medicines and those who did not.