scholarly journals Understanding the Battle for Universal Pharmacare in Canada Comment on "Universal Pharmacare in Canada"

2020 ◽  
Author(s):  
Marc-André Gagnon
Keyword(s):  
Prescription Drugs ◽  
Access To Medicines ◽  
Academic Community ◽  
Drug Coverage ◽  
Value For Money ◽  
Drug Access ◽  
Canadian Population ◽  
Overwhelming Evidence ◽  
Appropriate Prescribing ◽  
Catastrophic Coverage

Drug coverage in Canada is a patchwork; an inequitable inefficient and unsustainable patchwork with no coherence or purpose. Some people think that we can solve the problem by adding more patches, but the core of the problem is that it is a patchwork. For the working population, access to medicines is still organized as privileges offered by employers to their employees. Universal pharmacare would not only provide better access to needed prescription drugs, but also eliminate waste, ensure value-for-money and help improve drug safety and appropriate prescribing. Opponents fear that a universal pharmacare plan would ration drugs, and impede drug access for some patients. However, these claims misunderstand the reality of drug coverage, pricing and access. Opponents propose, instead, to "fill the gap" of current drug coverage by implementing catastrophic coverage, which would serve commercial interests without maximizing health outcomes for the Canadian population. In spite of overwhelming evidence and consensus in the academic community in favour of universal pharmacare, the battle is far from over.

Adverse Selection in Retiree Prescription Drug Plans

2006 ◽  
Vol 9 (1) ◽  
Author(s):  
Dana P Goldman ◽  
Geoffrey Joyce ◽  
Pinar Karaca-Mandic ◽  
Neeraj Sood
Keyword(s):  
Adverse Selection ◽  
Prescription Drugs ◽  
Claims Data ◽  
Drug Coverage ◽  
Switching Behavior ◽  
Part D ◽  
Drug Benefits ◽  
Prescription Drug Plans ◽  
Plan Selection ◽  
Independent Effects

We used claims data from a large U.S. employer that introduced changes in its medical and drug coverage offerings in 2002 for non-Medicare eligible retirees. In addition to the existing plans, the employer introduced two new plans in 2002 that were less generous both in terms of medical and drug coverage. Further, one of the new plans had an annual benefit limit of $2,500 on prescription drugs, similar to the “doughnut hole” in the standard Medicare Part D benefit. We examined beneficiaries switching behavior in response to the new choice set and estimated the independent effects of medical and drug benefits on plan selection. We found that beneficiaries in better health were more likely to switch to the new, less generous plans. While the generosity of the medical benefit played a more important role in choosing a plan, choices did not vary significantly by health status. In contrast, sicker individuals were more likely to enroll in plans with generous drug benefits. This suggests that drug coverage may be more susceptible to adverse selection than medical insurance.

Exploring Prescription Drug Coverage and Drug Use for Older Americans

2002 ◽  
Vol 36 (11) ◽  
pp. 1704-1711 ◽  
Author(s):  
David A Mott ◽  
Jon C Schommer
Keyword(s):  
Drug Use ◽  
Prescription Drug ◽  
Prescription Drugs ◽  
Older Persons ◽  
Insurance Coverage ◽  
Drug Coverage ◽  
Prescription Drug Coverage ◽  
Older Americans ◽  
Drug Insurance ◽  
Prescription Drug Insurance

OBJECTIVE: To describe existing prescription drug insurance coverage for older Americans, to describe out-of-pocket payment levels per prescription associated with service benefit prescription drug plans used by older persons, and to examine the association of prescription drug coverage types with the reported use of prescription drugs by older persons. PATIENTS AND METHODS: Data were obtained from a national survey of 1570 community-dwelling older persons (≥65 y) conducted in June 1998. A 2-part utilization model was estimated using logistic regression and ordinary least-squares regression. RESULTS: Data from 310 respondents were used for analysis. Overall, 66.1% of respondents reported having prescription drug insurance coverage. A majority (76.6%) of respondents having private drug coverage reported having a service benefit plan (requiring copayment or coinsurance amount to be paid for each prescription). The median copayment per brand name and generic prescription for persons reporting having coverage by service benefit plans was $10 and $5, respectively. CONCLUSIONS: Overall, a majority of older persons reported paying relatively small amounts out-of-pocket per prescription during 1998. Among persons who reported having drug insurance coverage, there were no statistically significant differences in the reported number of drugs used daily, regardless of out-of-pocket payment amount per prescription. Patient need and level of past drug use were significantly associated with both the likelihood of using any prescription drugs and the level of use among users. More research is needed to examine differences in drug expenditures and characteristics of drugs used across prescription drug insurance types for older persons.

scholarly journals THE LEGAL DUEL: THE TRIPS AGREEMENT AND DRUG ACCESS ISSUES

2015 ◽  
Vol 27 ◽  
pp. 345-349
Author(s):  
Jae Sundaram
Keyword(s):  
Developing Countries ◽  
Patent Protection ◽  
Access To Medicines ◽  
Trips Agreement ◽  
Direct Result ◽  
Drug Access ◽  
The World ◽  
The Subject ◽  
Chemical Products ◽  
Phd Thesis

The problem of access to medicines became acute with the entry of the Trade-Related Aspects of Intellectual Property Rights (TRIPS) Agreement in 1995 and caught a number of developing countries around the world, unawares. Brenda P Mey’s book on access to drugs issues is a study of this particular problem faced in two developing countries, namely India and Kenya in the aftermath of the implementation of the TRIPS compliant patent legislation. The two developing countries taken up for study are geographically located in two different continents, namely Asia and Africa with differing backgrounds and strikingly similar problems. Dr Mey’s book is a brainchild of her PhD thesis of the same title, and a library reference work in every sense. It showcases her talents as a researcher and analyst on the subject matter of lack of access to medicines (in this case India and Kenya) as a direct result from the implementation of TRIPS Agreement, which grants an extended patent protection to pharmaceutical and chemical products besides others.

scholarly journals Income-Based Drug Coverage in British Columbia: The Impact on Access to Medicines

2006 ◽  
Vol 2 (2) ◽  
Author(s):  
Patricia Caetano ◽  
Colette Raymond ◽  
Steve Morgan ◽  
Lixiang Yan
Keyword(s):  
British Columbia ◽  
Access To Medicines ◽  
Drug Coverage ◽  
The Impact

Not a good buy: Value for money of prescription drugs sold on the Internet

Health Policy ◽  
2012 ◽  
Vol 106 (3) ◽  
pp. 241-245 ◽  
Author(s):  
Rosella Levaggi ◽  
Claudio Marcantoni ◽  
Laura Filippucci ◽  
Umberto Gelatti
Keyword(s):  
Prescription Drugs ◽  
The Internet ◽  
Value For Money

The Struggle for the Soul of Medicare

2004 ◽  
Vol 32 (3) ◽  
pp. 410-415 ◽  
Author(s):  
Bruce C. Vladeck
Keyword(s):  
Interest Groups ◽  
Prescription Drugs ◽  
Subject Matter ◽  
Direct Mail ◽  
Subject Matter Experts ◽  
Mass Mobilization ◽  
Grass Roots ◽  
Catastrophic Coverage ◽  
Good Coverage ◽  
Political Battle

Not so very long ago - in historical terms - the politics of Medicare were thought to be stable and well-established. Medicare’s 1965 enactment culminated an epochal political battle that spanned fifteen years and involved mass mobilization, millions of dollars in lobbying expenditures (including the development of such techniques as “grass-roots lobbying” and targeted direct mail), and bitter partisan controversy. By the late 1980s those seemed to be distant birthing pains long since overshadowed by the program’s robust health and popularity. Medicare politics had devolved into a model of pluralist “normalcy” in which a relatively specialized and autonomous group of subject-matter experts in the federal bureaucracy, the Congress, and affected interest groups largely made policy by negotiating among themselves, primarily on issues of provider reimbursement. Even the extraordinary events involving the 1988 enactment of the “Medicare Catastrophic Coverage Act” legislation (which, among other things, established good coverage for prescription drugs), and the ensuing public firestorm that led to its partial repeal in 1989, could be seen as an aberrational deviation from a more placid pattern.

scholarly journals Catastrophic Drug Coverage in Canada

2013 ◽  
Vol 2 (1) ◽  
pp. 1-9
Author(s):  
Karlo Franko Azores
Keyword(s):  
Prescription Drugs ◽  
Drug Coverage ◽  
Hospital Outpatient ◽  
Outpatient Prescription ◽  
Coverage Policy ◽  
Point Of Reference

There is currently no nationwide catastrophic drug coverage in Canada, and this creates many inequities with regards to the costs and accessibility of out-of-hospital (outpatient) prescription drugs. This paper examines why catastrophic drug coverage needs to be addressed as well as implemented in order to improve the inequities in provincial drug plans and the continued non-coverage of outpatient prescription drugs. This paper used the recommendation of the 2002 Romanow Commission as a point of reference for the need to implement catastrophic drug coverage in Canada. Moreover, the 2003 First Ministers’ Accord and 2004 First Ministers’ Meeting are used to reveal the government’s initiative to develop a Canadian catastrophic drug coverage policy that remains unaddressed and unimplemented to this day.

scholarly journals Universal Pharmacare in Canada: A Prescription for Equity in Healthcare

2019 ◽  
Vol 9 (3) ◽  
pp. 91-95
Author(s):  
Mohammad Hajizadeh ◽  
Sterling Edmonds
Keyword(s):  
Healthcare System ◽  
Prescription Drugs ◽  
Social Inequalities ◽  
Insurance Coverage ◽  
Universal Coverage ◽  
Pharmaceutical Products ◽  
Drug Coverage ◽  
Publicly Funded ◽  
Policy Makers ◽  
Out Of Pocket Expenses

Despite progressive universal drug coverage and pharmaceutical policies found in other countries, Canada remains the only developed nation with a publicly funded healthcare system that does not include universal coverage for prescription drugs. In the absence of a national pharmacare plan, a province may choose to cover a specific sub-population for certain drugs. Although different provinces have individually attempted to extend coverage to certain subpopulations within their jurisdictions, out-of-pocket expenses on drugs and pharmaceutical products (OPEDP) accounts for a large proportion of out-of-pocket health expenses (OPHE) that are catastrophic in nature. Pharmaceutical drug coverage is a major source of public scrutiny among politicians and policy-makers in Canada. In this editorial, we focus on social inequalities in the burden of OPEDP in Canada. Prescription drugs are inconsistently covered under patchworks of public insurance coverage, and this inconsistency represents a major source of inequity of healthcare financing. Residents of certain provinces, rural households and Canadians from poorer households are more likely to be affected by this inequity and suffer disproportionately higher proportions of catastrophic out-of-pocket expenses on drugs and pharmaceutical products (COPEDP). Universal pharmacare would reduce COPEDP and promote a more equitable healthcare system in Canada.

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