Handy facts about access to drugs
The Society supports establishing national standards for the provision of drugs that are required in the medical management of cancer. We believe all Canadians must have the same access to appropriate, high-quality and timely services, regardless of where they live or whether the drugs are delivered in hospital or in the community.
The following are some handy facts about access to drugs that you can use when speaking with, or writing to your local media and politicians.
- According to the Canada Health Act, only drugs provided during a hospital stay are provided free of charge.
- 45% of cancer drugs were administered outside of hospitals in 2006 and often the patient is responsible for paying for their treatment.
- One-fifth of Canadians are not insured for routine drug costs.
- Spending on drugs is the fastest growing expenditure of the health care system and is expected to grow faster (8.3%) than spending on hospitals (5.8 %) or physicians (6.2 %).
- In 2005, $20.6 billion was spent on outpatient prescription drugs, including over-the-counter and personal health products purchased as a result of a prescription or paid by a third-party insurer. Of this sum, $4 billion represents direct out-of-pocket expenditures by patients.
- According to the Canada Health Act, only drugs provided for a patient during a hospital stay are required to be provided free of charge. Drugs that are prescribed for people after their hospital stay do not have to be provided free.
- Changes in cancer treatment have meant that patients increasingly receive treatment outside of the hospital setting. As a result, the costs associated with this change have often been shifted to the patient.
- Most Canadians have some form of drug insurance, either through provincial programs for the elderly (or other high-needs populations) or through employer-based benefits plans. However, much of this coverage is subject to caps, co-payments or restrictions.
- The working poor, middle-class and self-employed who have paid into the health system all of their lives are the most vulnerable, and many are unaware of the situation until they face a cancer diagnosis.
- Significant disparities exist between drug plans as to what drugs are covered and/or how they can be used. These discrepancies are based largely on
- individual provinces’ cost-containment goals
- the priority of cancer within a province’s healthcare system
- how appropriate utilization of drugs is defined
- the drug plan’s interpretation of what constitutes acceptable value for money
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