OP-ED: Cheaper drugs an integral part of health reform

April 13, 2012

The StarPheonix

Dr. Ryan Meili

Meili is a doctor in Saskatoon and vice-chair for the group, Canadian Doctors for Medicare.

Glen is a patient of mine who works full time at a grocery store in Saskatoon. It's what you might call an entry-level job, but given his level of education, experience and age (he's in his mid-50s), it's the level where he's likely to stay.

With housing, food and other costs rising, and his wages staying the same, it's increasingly difficult for Glen to afford anything but the basic necessities. Complicating the situation further, he has Type 2 diabetes and is on three medications to control his blood sugar.

He was doing reasonably well with this, but one of the medications is quite expensive, and when his previous doctor's office stopped getting free samples he couldn't afford to take it anymore. As a result, his blood sugars have spiked, putting him at increased risk of complications from his diabetes, such as vision loss or kidney failure, which could make it even harder for him to make ends meet.

His story is not unique. In fact, his situation is distressingly common, with a recent study in the Canadian Medical Association Journal showing that one in 10 Canadians go without necessary medications due to cost. That number rises to one in three among low income Canadians.

It's certainly a problem I see in my practice all the time. Not only does this lead to worse health outcomes for those already at the highest risk for ill health, but it also leads to increased costs for the health system, as failure to prevent and treat early lead to more severe illness and expensive hospital care.

This all brings into question the wisdom of the Saskatchewan government's decision to increase the cost per prescription for children and seniors to $20 from $15.

A $5 difference may not seem like much, though with many seniors on six or more medications, it does start to eat into fixed incomes.

The higher fee is a step in the wrong direction, especially when there are far better ways to deal with paying for medications.

Michael Law and Steve Morgan at the University of British Columbia propose a Priority Drug Program that would cover carefully selected drugs for Canadians at little or no cost to the patient. We could start with low-cost generics and, by bulk purchasing, reduce the cost of drugs further to the point of being able to provide essential medicines to Canadians at no charge.

There is growing evidence that providing prescription drugs at low cost, or even no cost, is not only good for patients, but it makes economic sense.

A recent study in the New England Journal of Medicine showed that providing medications to heart attack patients resulted in more people taking their medications as prescribed and having fewer complications. These improved health outcomes didn't cost more. Despite paying for prescription drugs, the overall cost to the health insurer did not increase because patients needed less of the costly interventions associated with complications.

With rigorous review processes and more aggressive price negotiations, it has been estimated that a national pharmacare program could generate savings of up to $10.7 billion.

Saskatchewan's decision to increase drug payments for seniors and children shifts the burden of growing drug costs onto those who may be least able to afford it. And it reduces the burden on the government to find better solutions to increasing drug costs.

Premier Brad Wall, as co-chair of the Council of the Federation's Working Group on Innovation in Health Care, has been showing leadership at the national level, urging the federal government and provinces to commit to health care innovation.

Canadian Doctors for Medicare is urging that the rising cost of prescription drugs and the innovative measures available to control that cost be at the forefront of that discussion. We hope that the decision to increase drug costs for seniors and children in Saskatchewan is not a sign that this essential reform is being excluded from the premier's innovation agenda.

Read the article on The StarPheonix website here.

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