Issue link: http://clhia.uberflip.com/i/406567
1 1. INTRODUCTION Prescription drug coverage in Canada is a mixed public and private accountability and must be fundamentally reformed if it is to serve Canadians well in the long-term. There are a number of concerns that need to be addressed going forward to ensure its sustainability, not the least of which is the continuing growth in the total cost of prescription drugs for all payers. Canada ranks second highest, behind the U.S., in total per capita spending on drugs (both prescribed and non-prescribed) of 25 OECD countries. If Canada were able to implement reform to move us more in line with the median of the OECD in this regard, we would save over $9.6 billion per year in drug costs. This is money that provinces can use to reduce their deficits, employers can use to grow their businesses and create new jobs and workers can use for other priorities. Moreover, spending on prescription drugs over the past decade has grown faster than any other category of health care expenditures. 1 The loss of patent protection for a number of blockbuster brand drugs, coupled with aggressive generic pricing reform by the provinces for the benefit of all payers, has resulted in a moderation in the growth of drug cost in the last couple of years. However, most experts feel that we are coming to the end of a period of relative calm and that the ongoing financial sustainability of drug plans in Canada is far from assured. Better managing the overall cost of drugs going forward is critical. Plan sponsors, typically employers, include drug benefits as part of a competitive supplementary health plan in order to attract and retain employees, as well as to ensure a healthy and productive workforce and, ultimately, they must bear the costs of drugs. However, employers have limited resources and do not have to provide supplementary health plans with drug benefits to their employees. The key concern from a sustainability perspective is how to manage the recent and forecasted increase in the number of high cost drugs and drug therapies available and being prescribed to 1 Canadian Institute for Health Information (CIHI). Drug Expenditure in Canada, 1985 to 2010. April 2011.