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Access to Care

Reducing the Cost of Pharmaceuticals in Canada

Canada is well-known for its universal healthcare system, which provides all citizens and permanent residents with access to medically necessary hospital and physician services without direct charges at the point of care.

Yet, when it comes to prescription medications, the picture is somewhat different. While Canada has lower drug prices than many countries, some Canadians still face significant out-of-pocket expenses.

Fortunately, several strategies and programs are available to help Canadians reduce the cost of pharmaceutical drugs. This article will summarize some of the primary methods Canadians can use to access medications at reduced or subsidized prices.

1. Provincial and Territorial Drug Benefit Programs:

Each province and territory in Canada has its drug benefit program to help cover the costs of prescription drugs for specific populations, often based on age or income. For instance:

  • Ontario offers the Ontario Drug Benefit (ODB) program, which covers eligible drug costs for seniors, individuals residing in long-term care homes, and those on social assistance.
  • British Columbia has the PharmaCare program, which offers income-based assistance to residents. To take advantage of these programs, residents typically need to apply and meet certain eligibility criteria.

2. Private Insurance:

Many employers offer private health insurance as part of their benefits packages. These insurance plans can cover a portion of prescription drug costs, reducing out-of-pocket expenses for the insured. It’s essential to understand the specifics of your plan, including co-pays, deductibles, and the list of covered medications.

3. Patented Medicine Prices Review Board (PMPRB):

The PMPRB is a federal agency responsible for ensuring that the prices of patented medicines sold in Canada are not excessive. While consumers do not interact directly with the PMPRB, its work indirectly benefits Canadians by keeping drug prices in check.

4. Generic Drugs:

Generic drugs are bioequivalent versions of brand-name drugs that usually come at reduced cost. When a prescription is written, Canadians can ask their pharmacists if a generic version of the medication is available. In many cases, switching to a generic can result in significant savings without compromising on treatment efficacy.

5. Patient Assistance Programs:

Several pharmaceutical companies operate patient assistance programs that offer certain medications at reduced prices or even for free to qualifying individuals. These programs are often designed for patients without insurance or those who cannot afford their medications due to financial hardships. It’s worth checking the drug manufacturer’s website or contacting them directly to see if such a program is available for a specific medication.

6. Bulk Purchasing:

Some provinces have formed alliances to negotiate and buy drugs in bulk, achieving better prices due to the higher purchasing volume. As a result, patients in these provinces may benefit from lower prices on certain medications.

7. Comparison Shopping:

Prices for the same drug can vary between pharmacies. Before filling a prescription, it might be worthwhile to compare prices at different pharmacies. Some online platforms and apps can help Canadians compare drug prices and find the best deals.

8. Tax Deductions:

Canadians can claim the cost of prescription drugs as a medical expense on their income tax return, which can result in tax savings. Ensure you keep all receipts and consult with a tax professional about eligible expenses.

9. Private Health Service Plans

Private Health Services plans (PHSPs) allow business owners and incorporated professional to use business income to pay for the personal medication costs of the business owner (as well as their employees). The medications are payed for without the owner/employee  paying any extra taxes for the benefit, and the business can claim the healthcare expenses as tax deductions. Providers such as CarbonFibre Financial offer self-administered private health services plans

10. National Pharmacare:

There’s ongoing debate and advocacy for the establishment of a national pharmacare program in Canada, which would offer universal drug coverage to all Canadians, similar to the existing healthcare system. If such a program is implemented in the future, it could significantly reduce or eliminate out-of-pocket expenses for prescription medications.

In Conclusion:
While Canada boasts a healthcare system that is the envy of many countries, prescription drug costs remain a concern for many citizens. However, by being informed and proactive, Canadians can utilize several avenues to reduce their medication expenses. Whether through provincial programs, exploring generic options, or tapping into patient assistance programs, a combination of strategies can help ensure that necessary medications remain accessible and affordable.