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Xolair co pay card7/2/2023 ![]() ![]() The kinds of examples that I referred to in my presentation are not just anecdotal from my own practice, but come from qualitative research and from speaking to family physicians across the country who talk about the kinds of things that they have to do. She was quoted as saying that we simply don't need easily abused long-acting oxycodone drugs to achieve better care. ![]() All Canadians want to have access to the pharmaceuticals and treatments that they need. When we hear stuff like that, it just tears our hearts out, because you want to do the best. She said it has devastated many first nations communities, including one small northern reserve where 85% of residents are addicted to opioids. She mentioned the challenge with first nations communities, where the federal government does cover prescriptions. She said that Ontario had the highest rate of prescription narcotic abuse in the country, two to four times higher than any other province. She was out there urging all provinces and territories to band together to convince Health Canada to block generic forms of opioids. I remember Deb Matthews in Ontario a few years ago, the frustration. I know that different governments have taken different approaches, and I remember a controversial one for the opioids. I know we're trying to get our heads around what the role of the federal government is. So it would also be an opportunity to keep costs down under the public plan while still having some viable market for the private insurers either to cover the $15 or $20 copayments or to cover medicines that just didn't make the mark because they weren't proven value for money. ![]() For those of us who have moderate to middle incomes, we might pay $15 or $25 per prescription under the universal drug plan, and indeed, we might continue to have a parallel private insurance benefit to cover the costs of those prescriptions. If you wanted to limit the public expenditure on a universal public pharmacare program, you would devise a carefully chosen formulary and you would have patients make some contribution toward their prescription costs with notable exceptions for low-income individuals or people with chronic disease. The other thing we did in this model, particularly in the worst-case scenario for government, is we assumed there would be virtually no copayments in the worst-case scenario, which again is something that no province in Canada currently does for general beneficiaries, and in fact, only a few countries around the world do, notably Scotland and Wales, which provide universal coverage at no copayments. In that context, it should not surprise any of us that one in five Canadian households now reports that someone in the household does not fill a prescription due to concerns about costs. For people who can't afford those catastrophic deductibles of 3%, 5%, 10%, or 12% of their income, having access to catastrophic drug coverage is equivalent to not having any drug coverage at all. This requires an upfront cash outlay that a person living on $20,000 a year simply can't afford, so what happens is that people just don't fill their prescriptions. To give you an example, in Ontario, where I live, on an income of $20,000 annually, a patient would need to spend $800 out of pocket before her coverage would kick in. It is really important to understand how unhelpful catastrophic drug coverage is for the patients in my practice and practices across the country: people living with diabetes, high blood pressure, asthma, chronic heart disease, and chronic lung disease. As you know, those catastrophic plans are supposed to kick in to save people from having to mortgage their homes in order to pay for their drugs. Every province, and also the federal government, runs at least one public drug plan, but most Canadians with jobs are excluded from public plans, despite the fact that they may not receive coverage through their employer, unless their costs become what is known as “catastrophic”. Now let's talk about our public insurance plans. ![]()
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