Catastrophic drug costs

Imagine moving to Ontario from another province and finding out that the costs of your expensive prescription cancer medications aren’t covered in your new home. Even though the Canada Health Act provides for comparable levels of medical care from province to province, the same isn’t true when it comes to expensive life-saving medicines.

Many Canadian families still face catastrophic drug costs (defined as greater than three per cent of net household income), even in provinces where universal coverage exists.

Most provinces have catastrophic drug plans, but each has a different mechanism for determining which drugs are covered. The Canadian Cancer Society (CCS) is calling for the development of a national catastrophic drug insurance program to help create a consistent, coordinated approach to coverage across Canada. Joanne Di Nardo, senior manager of public issues for the Ontario division of the CCS, encourages Ontario voters to ask local candidates running in the upcoming provincial election about their level of support on cancer issues.

“A national catastrophic drug insurance program has been an election issue for many years,” says Di Nardo. “Ontario should take a leadership role in partnership with other provinces to encourage the federal government to establish a national catastrophic drug insurance program. Action is needed now to alleviate the gaps and disparities in coverage for cancer drugs that currently exist in Canada.”

There are no agreed-upon standards concerning which drugs should be covered or the out-of-pocket expense required from patients. Each of Canada’s 19 public drug plans, and a variety of private plans, make widely different decisions regarding listings, reimbursement, co-payments and lifetime limits. Therefore, significant disparities exist between provinces and between public and private insurers.

“These disparities result in a growing trend away from universal care towards health care by postal code and pocketbook,” says Di Nardo.

A system of catastrophic drug coverage was promised in the 2004 Health Accord, and, in September 2008, provincial and territorial health ministers issued a statement saying they held ‘a common view that catastrophic drug coverage is as essential to Canadians as physician and hospital coverage.’

“Ontarians are growing increasingly impatient that no action has been taken,” says Di Nardo. “Make sure your local provincial politician knows how you feel about this issue.”

For more information, go to www.cancer.ca/OntarioElection2011 

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