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Council’s pharmacare survey reveals concerns with high cost of drugs and dispensing fees

The Council of Canadians recently conducted a survey asking people to share their experiences accessing medications during the COVID-19 pandemic.

With a record number of people losing their jobs, some are also losing access to employer-paid benefits plans that cover the cost of prescription medications. To date, more than 8 million people have applied for Canada’s emergency response benefit (CERB).

Just over 60 per cent of the more than 1,500 people who responded to our survey to date say they currently do not have an employer-paid benefits plan. Seventy-four per cent say they are finding it difficult to pay for their medications right now.

One woman, whose husband recently lost his job with employer-paid benefits, said her family is facing some impossible choices. “I now have to choose between losing our house or getting medication. Going without [medication] may cause my condition to flare up, which renders me completely bedridden so I will then lose my job.”

High drug prices

According to the federal government, “Canada’s drug prices are now the third highest among the Organization for Economic Co-operation and Development (OECD) countries – that is about 25 per cent above the OECD median.”

Many survey respondents talked about the high costs of medications.

“Between my husband and [I], we spent over $1,000 per year on our prescription medications,” said one woman.

“I am a diabetic on insulin, [which] explains some of our high costs. In 2019 my spouse was diagnosed with cancer, and we have faced a heavy pharmaceutical cost because of that. In total, our needs cost us close to $500 a month,” revealed a man.

Another respondent who asked to remain anonymous said he struggled as a self-employed business owner to find ways to pay for medications. “I am more financially stable than most people I know with chronic medical needs, and I’m still struggling,” he said. “Our health system already pays for access to physicians, medical tests and hospital care. It defies logic that medication to treat conditions identified through those venues isn’t covered. It creates a system where only the wealthy and able-bodied can afford consistent and appropriate care.”

Some can’t access the medications doctors say they need due to high costs.

“I am frustrated about the current state of pharmacare,” said one woman. “I was told that I would be a good candidate for immunotherapy. The cost per injection would be $1,000. My husband’s coverage has a $50,000 limit for my life. Because of the lack of coverage, I have to take a combination of other medications that cost $500 per month. That way I can make my insurance last longer.”

Need benefit plans

Others say they are specifically staying employed, even with bad working conditions, because it gives them access to drug benefits.

“I’m very fortunate to have a job that provides great benefits. It wasn’t always this way. Our union fought long and hard to achieve our benefit package. I wish all workers could have what we do. Indeed, it’s why I’ve stayed with the job so long. We have a diabetic son, and two other children. My husband did not have benefits so mine were crucial for our family,” said one woman.

“If I were to lose or leave my job I would not be able to afford my current medications,” said Seanna Quressette. “I would have to decide between my mental health and food or rent as my medications cost more than $1,000 a month. I am also pre-diabetic and know that if I were to add the cost of diabetes medication to my profile I would not be able to afford rent. We need a national plan.”

Others worry what happens when they are in between positions.

“I’m very lucky that the employer that laid me off is willing to pay for three months of coverage before my end date,” said one survey respondent. “I know this is not the case for many. If that coverage and the CERB both run out and I am still not working, we will have to budget very carefully. The cost of the biologic that I take for Crohn’s Disease is well beyond what 99 per cent of the population could ever pay on an ongoing basis.”

One woman said she was recently laid off. She found a new job, but it has a three-month waiting period for benefits. “I am terrified and scared for the future. What will happen if we can’t afford medications? I used to get three months now I only get one month and that will not cover the time I will be without benefits.”

Canada’s supply chain for medications is fragile

Several people responding to the survey raised concerns about the fragility of Canada’s supply chain for medications.

“Supplies for some of my medication have been short,” shared one woman. “Luckily, there was enough to carry me until the pharmacy could get more, and it’s one that can be interrupted safely if necessary. It raises concern about potential shortages of other medication I take, which comes with a high-risk dangerous side effects if interrupted abruptly.”

In response to supply concerns, pharmacies were instructed to limit filling prescriptions to only one month at a time even though many benefit plans allow three months at a time. This has resulted in people having to pay dispensing fees more often, which can run as high as $12 per prescription in some provinces. This additional cost has added to the financial burdens for many people. Of all survey respondents to date, 47 per cent said they face increased costs due to pharmacies’ monthly dispensing fees.

“I have no coverage of any kind, and today I had to renew five prescriptions. It came to just over $91, of which $50 was dispensing fees,” said one woman who was recently laid off due to COVID-19. “I decided I will try to take meds only every two or three days and see how that goes. I am in dire straits. I understand they don’t want to run out of any drugs, but the monthly fees are unbearable, on top of my current financial state. That is one of the reasons I will try to spread out my meds. I will keep watch over any worsening symptoms, but this is one way I have to think to stretch things.”

An overwhelming 96 per cent of survey respondents said they support a national pharmacare program.

“After being laid off because of COVID-19, everything, including prescription renewals, has become a balancing act of what can I afford this week,” shared one woman. “In a rich country like Canada, one that can waste billions of taxpayers’ dollars on a dying oil industry, there is absolutely no reason for not implementing a national pharmacare program. The only thing lacking is the political will.”