Canadian healthcare is not universal. Nowhere is this lack of universality more evident than in the payment for drugs in Canada. Canadians without the financial wherewithal cannot access orphan drugs for rare diseases and take-at-home oral cancer drugs and many other pharmaceuticals. In addition to the physical and emotional tolls experienced, patients and survivors and their families and caregivers bear the brunt of an ever-growing financial burden. This article outlines how this happened and what to do about it.
Bank of Montreal. Living to 100: Four Keys to Longevity. Toronto: Bank of Montreal; 2014.
5.
TaylorMG. Health Insurance and Canadian Public Policy. 2nd ed. Montreal: McGill-Queen’s University Press; 1987:492.
6.
NelsonC.The Financial Hardship of Cancer In Canada: A Literature Review. The Canadian Cancer Society Manitoba Division; 2010.
7.
Canadian Cancer Society (Manitoba Division), Canadian Cancer Action Network. Five Year Action Plan to Address the Financial Hardship of Cancer in Canada: A Call for Action. Canada: Canadian Cancer Society (Manitoba Division), Canadian Cancer Action Network; 2013:17–18.
KennedyB. Benefits and Pension Monitor. Toronto: Powershift Communications; 2014:15.
11.
Hewitt—Post Retirement Healthcare Benefits in Canada Survey; Toronto: Aon-Hewitt, 2006.
12.
Aon—Canadian Benefits Trends Survey; 2006.
13.
Author’s calculation based upon 2013 Statistics Canada Employment by Industry data: Toronto: Aon-Hewitt.
14.
The Rx&D International Report on Access to Medicines, 2009/2010. Ottawa: Canada’s Research-Based Pharmaceutical Companies, 2010:17.
15.
MorganSKennedyJBootheK. Toward high-performing “Pharmacare” systems: a review of experiences in seven countries. In: Working Paper Presented at the 2008 Annual Conference of the Canadian Association for Health Services and Policy Research, Gatineau, Quebec, Canada, May 2008.
16.
MarxK. Das Kapital. Hamburg: Verlag von Otto Meisner; 1867: p.535.
17.
Canadian Health Policy Institute. Private Versus Public Drug Coverage in Canada. Canada: Canadian Health Policy Institute; 2014.
TaylorDW. Benefits outweigh costs in universal healthcare: business case for reimbursement of take-home cancer medicines in Ontario and Atlantic Canada. Am J Med Med Sci. 2014;4(4):126–138.
21.
TaylorDW. The Institutionalized Discrimination of Cancer Patients—Not What Tommy Douglas Intended: A Business Case for the Universal Coverage of Oral Cancer Medicines in Ontario and Atlantic Canada. Cambridge, ON: The Cameron Institute; 2014.
22.
OgailyM. Give patients equal access to drugs [published on-line November 15, 2013]. Lansing State J. 2013.
LongoCFitchMDeberRWilliamsAP. Financial and family burden associated with cancer treatment in Ontario, Canada. Support Care Cancer. 2006;14
(11):1077–1085.
27.
TsimicalisA. Costs Incurred by Families of Children Newly Diagnosed with Cancer in Ontario. Toronto: University of Toronto; 2010.
28.
BoothCMLiGZhang-SalomonsJMackillopWJ. The impact of socioeconomic status on stage of cancer at diagnosis and survival: a population-based study in Ontario, Canada. Cancer. 2010;116
(17):4160–4167.
29.
KeelerEB. Effects of cost sharing on use of medical services and health. J Med Pract Mgmt. 1992;8(1):11–15.
30.
FreemanRLybeckerKMTaylorDW. The Effectiveness of Disease Management Programs in the Medicaid Population. Hamilton ON: The Cameron Institute; 2011.
31.
TamblynREgualeTHuangAWinsladeNDoranP. The incidence and determinants of primary nonadherence with prescribed medicines in primary care: a cohort study. Ann Intern Med. 2014;160
(7):441–450.
32.
MarxKEngelsF.Communist Manifesto. London: von J.E. Berghord, 1848:chapter 3.
33.
NietzscheF. Human, All too Human. Chemnitz, DE: Verlag von Earnst Schmeitzner; 1878:494.
A Ponzi scheme is a fraudulent investment scheme wherein the manager of the scheme pays returns to the investors from new funds to the manager by new investors, rather than from profit earned by the manager. Web Site. http://en.wikipedia.org/wiki/Ponzi_scheme. Accessed November 3, 2014.
36.
Canadian Health Policy Institute. The Cost of Patented Drugs in Canada. Toronto: Canadian Health Policy Institute. 2013, p.14.
37.
IMS Brogan. Private Drug Plan Drug Cost Forecast; Montreal: IMS Brogan, 2013.
38.
Canadian Institute for Health Information. National Prescription Drug Utilization Information System Database. Ottawa: Canadian Institute for Health Information; 2012.
39.
HazlittH. Economics in One Lesson. New Rochelle NY: Arlington House; 1979, p.103.
40.
LazarF. How Ottawa Rewards Mediocrity. Toronto: University of Toronto Press; 1996.
RawsonNSB.Potential Impact of Delayed Access to Five Oncology Drugs in Canada; 2013; this figure is conservative considering that the National Institutes of Health in the US uses a figure of $270,000 as in Cancer Trends Progress Report—2009/2010 Update. National Cancer Institute, NIH, DHHS, Bethesda MD; April 2010. Web site. http://progressreport.cancer.gov. 2005 base figure $225,000 inflated by US CPI 2005-2012 for comparative purposes and assuming USD-CND parity. Accessed March 4, 2011.
The Cameron Institute, Rx&D, CIHR, ACAHO. Canadian Clinical Trials Summit - Starting the conversation. Ottawa: Rx&D, 2011.
45.
FaithKE. The role of values-based leadership in sustaining a culture of caring. Healthc Manage Forum. 2013;26
(1):6–10.
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
