Health Care Expenditure

The Canadian Institute for Health Information (CIHI) pegged the expenditure for prescription drugs at roughly $29 billion in 2014. This cost is shared between individuals, private plans, federal government plans and provincial/territorial plans. Public drug plans pick up about 42% of those costs and 58% is paid by individuals, either through employer supported benefits or out of pocket. Prescription drug costs represent 13.4% of total health care expenditures.

Any expenditure of this magnitude is prone to large vested interests and prescription drug spending is no exception. A shift to pharmacare will require significant political will. There will be winners and losers. Current expenditure includes the product, as well as the staff required

In this vein, it is essential that policy makers look beyond discussions just concerning the cost of such a program and incorporate a focus on value. In health care debates, stakeholders often turn to arguments concerning cost of programs and treatment, instead of taking the time to consider the additional non-monetary value. For example, a basic value statement may be ascribed to each stakeholder group:
1. The public values an improvement in their quality of life;
2. Employers seek the increased productivity associated with good health of their employees;
3. Governments are after improved population health, individual satisfaction and system sustainability (triple-aim);
4. Industry hopes to have timely access and an ability to sell their products in the market;
5. Insurance providers aim to minimize the number of clients on long-term disability;

Despite this, patients remain focused on attaining access to clinically necessary products, regardless of their ability to pay and expect that the system be responsive and timely with minimal delays. As a result of systemic barriers to access, advocacy has come to be not only prominent, but also necessary for many patient subsets. This is especially true for those who rely on long-term therapies for chronic conditions such as rare disease and autoimmune disorders.

Therefore, from a patient’s perspective, the objective of a universal pharmacare system is to remove obstacles to ensure that everyone has access to medically necessary treatments, irrespective of their financial situation. This includes individualized care that allow patients to access exceptional therapies should the usual and customary not be tolerated or prove