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Scrimping on meds to save cash most prevalent in B.C.

Patients here more cost-averse in using medicine than rest of Canada
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Health minister Mike de Jong (left) and NDP leader Adrian Dix (right).

A new study has found B.C. patients are much likelier than other Canadians to refuse to take prescribed medicine because of the cost.

The Canadian Medical Association Journal analyzed 2007 Statistics Canada survey data and found 17 per cent of B.C. residents did not follow prescriptions as directed in order to save money in the previous year.

That was more than double the 7.2 per cent rate reported by Quebecers and well above the national average of 9.6 per cent of respondents who scrimped on their drugs to save cash.

Failing to fill or refill a prescription on time or skipping doses can make treatment less effective and worsen chronic diseases, the journal noted.

"We did not expect that cost-related non-adherence would be highest in British Columbia," the CMAJ research paper said.

"This finding might result from the province's high-deductible public drug plan or the high level of personal debt among its residents."

The CMAJ report said providing better coverage to improve prescription use would likely reduce spending in other areas, such as acute care admissions to hospital.

Health Minister Mike de Jong said he wants the disparity between B.C. and the rest of the country investigated further.

Prescription drug costs are entirely covered, with no deductible, for more than 270,000 low-income patients in B.C. – the poorest 10 per cent.

"We need to take a closer look at why some residents report having challenges accessing prescriptions," de Jong said in a statement.

He noted a 40-year-old on social assistance who racks up nearly $1,400 in drug costs to control hypertension should pay nothing out of pocket, while other categories of low-income patients might pay around 30 per cent of their true drug cost themselves.

NDP leader Adrian Dix said he believes the problem is not the poor but middle-income earners who struggle against high housing prices and rising health premiums, ICBC premiums, electricity rates and other costs.

"It shows the growth in inequality and how much pressure there is today on middle-income people," Dix said. "One in six people are not taking the drugs they need because it's too expensive – twice as much as anywhere else."

The CMAJ study found underuse of prescriptions due to cost was most prevalent among low-income earners without medical insurance – more than 35 per cent reported doing it.

But nearly 15 per cent of the highest-income earners without insurance also resorted to the practice – more than the lowest-income earners with insurance.

Dix argued B.C. could have done much more to keep a lid on pharmaceutical prices, which have skyrocketed over the past 20 years, had it been more prepared to stand up to drug companies.

He noted B.C.'s pricing structure charges patients more for generic drugs – 35 per cent of brand name cost – compared to just 25 per cent in Ontario and Quebec.

The health ministry said B.C. has the lowest per capita drug expenditure in the country at $573 per person and provides more extensive drug coverage on many fronts.