The consequences of patient charges for prescription drugs in Canada: a cross-sectional survey

Law, Michael R.; Cheng, Lucy; Kolhatkar, Ashra; Goldsmith, Laurie J.; Morgan, Steven G.; Holbrook, Anne; Dhalla, Irfan A.

doi:10.9778/cmajo.20180008

Cited by 64 publications

(65 citation statements)

References 30 publications

(33 reference statements)

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“…(2,3, Since several of these studies used the same source survey. (3,38,39,43,45,46,54,55) the total sample size of unique participants across all 26 studies is uncertain. Assuming that each study's participant is a unique individual, the total sample size is 497,534.…”

Section: Study Characteristicsmentioning

confidence: 99%

Cost-Related Medication Nonadherence in Canada: A Systematic Review of Prevalence, Predictors, and Clinical Impact

Holbrook

Wang

Lee

et al. 2020

Preprint

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Background Cost-related nonadherence to medications (CRNA) is common in many countries and thought to be associated with adverse outcomes. The characteristics of CRNA in Canada, with its patchwork coverage of increasingly expensive medications, is unclear. Objectives Our objective in this systematic review was to summarize the literature evaluating CRNA in Canada in three domains: prevalence, predictors, and effect on clinical outcomes. Methods We searched MEDLINE, Embase, Google Scholar, and the Cochrane Library from 1992 to December 2019 using search terms covering medication adherence, costs, and Canada. Eligible studies, without restriction on design, had to have original data on at least one of the three domains specifically for Canadian participants. Articles were identified and reviewed in duplicate. Risk of bias was assessed using design-specific tools. Results: Twenty-six studies of varying quality (n=483,065 Canadians) were eligible for inclusion. Sixteen studies reported on the overall prevalence of CRNA, with population-based estimates ranging from 5.1% to 10.2%. Factors predicting CRNA included high out of pocket spending, low income or financial flexibility, lack of drug insurance, younger age, and poorer health. A single randomized trial of free essential medications with free delivery in Ontario improved adherence but did not find any change in clinical outcomes at one year. Conclusion: CRNA affects many Canadians. The estimated percentage depends on the sampling frame, the main predictors tend to be financial, and its association with clinical outcomes in Canada remains unproven.

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Section: Study Characteristicsmentioning

confidence: 99%

Cost-Related Medication Nonadherence in Canada: A Systematic Review of Prevalence, Predictors, and Clinical Impact

Holbrook

Wang

Lee

et al. 2020

Preprint

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“…The impact of this high spend translates into approximately 5.5% of Canadians reporting that they skip, stretch or simply do not take their medications. 6 However, for those with mental health conditions the rates are much higher, with 21.4% reporting that they are unable to afford their medications. 6 …”

Section: The Canadian Patchworkmentioning

confidence: 99%

“…6 However, for those with mental health conditions the rates are much higher, with 21.4% reporting that they are unable to afford their medications. 6 …”

Section: The Canadian Patchworkmentioning

confidence: 99%

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Drug coverage in Canada: gaps and opportunities

Clement

Memedovich

2018

jpn

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“…These two articles both raise this concern, thus joining a larger body of work that suggests there is evidence that some Canadians may be struggling to cover the costs of their prescription medicines. [10][11][12] However, they fail to point out that, under existing programs, lower-income Canadians already have access to some form of provincial insurance that limits out-of-pocket costs for prescription drugs to a minimal share of income, if not more extensive coverage, in every Canadian province. 13 These articles, and the public discourse in general, lack a clear understanding of the coverage that is already available to the most vulnerable subsets of the Canadian population who may be at higher risk of foregoing their prescriptions due to cost: those with lower incomes (including seniors), the disabled, and patients with chronic medical conditions.…”

mentioning

confidence: 99%

The Challenges of Canadian Pharmacare Are More Complicated Than Acknowledged Comment on "Pharmacare in Canada"

Lybecker

2020

Int J Health Policy Manag

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This commentary considers two editorial pieces, written by Hajizadeh and Edmonds, and Lewis, which address universal pharmacare in Canada. The pieces focus on the social inequities of the existing system and the challenges of successful implementation. After identifying the significant strengths of both articles, this commentary then delves into the reasons why universal pharmacare may not be the solution, and identifies numerous thorny issues that will complicate the implementation of such a publicly funded program. Both discussions point to the need for caution and transparency going forward.

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The consequences of patient charges for prescription drugs in Canada: a cross-sectional survey

Cited by 64 publications

References 30 publications

Cost-Related Medication Nonadherence in Canada: A Systematic Review of Prevalence, Predictors, and Clinical Impact

Cost-Related Medication Nonadherence in Canada: A Systematic Review of Prevalence, Predictors, and Clinical Impact

Drug coverage in Canada: gaps and opportunities

The Challenges of Canadian Pharmacare Are More Complicated Than Acknowledged Comment on "Pharmacare in Canada"

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