Government efforts to control drug costs should not be undertaken in ways that restrict patient access to therapeutics which could improve long-term health and improve quality of life, increase costs borne by the patient, or restrict physicians’ options to prescribe.
Background and rationale
Pharmaceutical costs have been rising steadily in Canada and account for an ever-increasing percentage of total health-care costs. Each provincial and territorial government has a prescription drug plan providing some public support for the cost of prescription drugs because prescription drugs are recognized as being medically necessary.
To reduce the cost of prescription drug plans, some governments have implemented or are considering the implementation of programs such as “reference based pricing”, wherein a public drug plan reimburses a patient for the cost of the lowest priced drug within a designated therapeutic category. (British Columbia claims that reference-based pricing has reduced public expenditures for prescription drugs by as much as $50 million in one year). However, patients, physicians and pharmaceutical companies are concerned that programs like reference-based pricing focus primarily on reducing drug and diagnostic product costs without a corresponding regard for optimal patient care.
Some of the criticisms of government cost-containment programs include concerns that they:
impose higher drug costs on patients who wish to use a higher priced drug and who must pay the difference between the cost of a drug covered by a government plan and the cost of the drug they wish to use.
do not recognize the needs of patients to access a variety of therapies and treatments.
restrict physicians’ ability to prescribe the drugs they believe are most beneficial for their patients.
impose additional administrative burdens on physicians, which can be a barrier to access.