- OTTAWA -- Canadians spent
a mind-boggling $19.6-billion on prescription and non-prescription drugs
last year, almost half as much as they spent on hospitals and more than
they spent on doctors.
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- Total drug spending rose an estimated 8.1 per cent in
2003, far outstripping inflation, says a report released Tuesday by the
Canadian Institute for Health Information (CIHI).
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- Per capita spending on medicine more than quadrupled
from 1985 to 2003, to $620.
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- Among 11 industrialized countries ranked by the Organization
for Economic Co-operation and Development, only Japan, France and Hungary
devoted a larger share of health spending to drugs.
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- Even though drugs are not covered by medicare except
when administered in hospital, 47.2 per cent of the prescription drug bill
was financed by the public sector last year, up from 42.5 per cent five
years earlier.
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- The public share is likely to increase, since the 2003
health accord commits governments to coverage of so-called catastrophic
drug costs. Both the Liberals and Conservatives say they will uphold the
2003 accord.
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- Drug costs in Canada are regulated by the Patented Medicine
Prices Review Board, and are lower than U.S. prices. Yet drugs remain the
fastest-rising cost factor in health care.
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- "The increase in drug spending is occurring despite
relatively stable drug prices in Canada," says Paul Grootendorst,
a University of Toronto professor and adviser to CIHI.
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- "This points to a higher volume of drug use and
the entry of new drugs, which are generally introduced to the market at
higher prices."
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- Critics charge that manufacturers get around the federal
price regulations by introducing pricey new products which are not necessarily
better than existing products.
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- "Despite the prevailing wisdom that high-quality
therapeutics cost big bucks, we're overpaying for what we're getting,"
physician and author Michael Rachlis says in his recent book Prescription
for Excellence.
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- "Costs are spiralling upward because doctors tend
to overprescribe drugs, particularly to the elderly, and they tend to prescribe
new, expensive drugs when a cheaper alternative is available."
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- Yet Dr. Rachlis also concedes that some patients aren't
getting medicines they need.
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- There's a big regional variation in use of pharmaceuticals,
with per capita spending ranging from a low of $192 in Nunavut to a high
of $688 on Prince Edward Island.
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- The share of drugs in total health spending has risen
steadily from 9.5 per cent in 1985 to an estimated 16.2 per cent in 2003.
That's more than in the United States, where drugs accounted for 12.4 per
cent of total health spending.
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- Experts say that effective drugs can reduce the time
that people spend in hospital, thereby lowering overall costs.
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- But there is also a lot of concern about aggressive marketing
by the pharmaceutical industry.
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- From 1985 to 2001, total drug expenditure grew at an
average annual rate of 9.7 per cent, well beyond what can be attributed
to economy-wide inflation and growth in the population, says the report.
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