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Canadian Drug Coverage

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Addressing Gaps in Canadian Drug Coverage

According to Morgan and Boothe (2016), Canada's medicare system is the only one among developed countries that has universal public health insurance but does not also have universal prescription drug coverage. The amount of out-of-pocket (OOP) spending is an immense burden for many Canadians, accounting for 34.3% of private expenditures, (Hennessey et al., 2016); and in Ontario, one in three people do not have employer-provided health insurance (Barnes & Anderson, 2015). Moreover, “cost-related non-adherence to prescription drugs is associated with low-income households”, which may lead to poorer avoidable outcomes such as: increasing hospital admissions, worsening disease, and growing overall …show more content…

Patients that are unable to follow prescriptions as ordered, related to lack of coverage, escalate stress on the health care system; increasing physician and emergency department visits, which may have been avoidable if the medications were covered for all Canadians (Lexchin, 2017). There are various socio-political barriers to implementing a universal drug coverage plan in Canada. Primarily, the federal government’s Patented Medicine Prices Review Board (PMPRB), controls prescription and non-prescription prices by making comparisons of across seven selected Organization of Economic Co-Operation and Development (OECD) countries (Tang, Ghali, & Manns, 2014). However, these OECD comparative countries have higher medication prices. In fact, four of the seven OECD countries have the most expensive prices worldwide; consequently increasing Canadian prescription pricing. According to Morgan and Boothe (2016), another barrier to universal drug coverage in Canada stems from “pharmacare’s initially low place on the policy agenda” (p. 249). Healthy public policy development requires synergy between the public, policy makers, and institutions alike. If universal drug coverage has “less attention than other health policy debates” a political change is less likely to occur (p. 251).
A few key stakeholders include government, physicians, pharmaceutical and insurance companies, nurses and patients. Firstly, the government plays a significant role in the

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