Prescription Drugs | Spending in Canada has doubled in 20 years

In 2020, $33 billion was spent on prescription drugs in Canada, almost double the $17 billion recorded in 2001. This “striking increase” is likely to continue in the coming years, reveals a study conducted by Canadian researchers.

William Theriault
The Press

Doubled expenses

In both hospital and outpatient settings, the trend is the same: spending in 2020 is about twice as high as that of 2001. ‘external, it was just below 15 billion, and then almost 28 billion, ”explains assistant professor at the Faculty of Medicine at Laval University Jason Robert Guertin, who participated in the study.

Rise of biopharmaceuticals

These are affordable drugs, but affecting a large part of the population, which previously occupied the largest proportion of Canadian expenditure. Atorvastatin, which treats high cholesterol, then cost a few dollars a day but sold in large volumes. “At first, the big costs came from common chronic diseases,” notes the professor. Then a transfer was made towards biomedicines, which treat more specialized diseases with restricted groups of patients, but which are extremely expensive per unit. »

Heavyweight

Infliximab (1.2 billion), a chimeric monoclonal antibody that treats autoimmune diseases, was the most expensive on external sale in 2020. A 100 mg dose costs several hundred dollars. At more than $4,000 for 100 mg, pembrolizumab is the biggest expense in the hospital setting. Canadians spent over $360 million to get it in 2020.

Unsustainable pace

The annual growth rate of prescription drug spending has, on average, climbed 4% in pharmacies and 7% in hospitals between 2001 and 2020. These are increases to watch out for, warns Jason Robert Guertin . “Ultimately, you can’t have constant spending that lasts for decades,” says the researcher. We can’t always increase like that. The fact that we spend so much reflects our past collective choices and those of our decision makers. »

RAMQ: 5.4 billion

The Régie de l’assurance maladie du Québec (RAMQ) has indicated to The Press only for the 2020-2021 fiscal year, therefore from 1^er April 2020 to March 31, 2021, “the total cost of drugs and pharmaceutical services provided to all persons insured by the Régie reached more than 5,410 billion”, an increase of 5.1% compared to the previous year .

Private is more expensive

In the province, people who are covered by private drug insurance must pay an average of $9.35 more than those who subscribe to the public drug insurance plan of the RAMQ, for the same drug. This means that the private costs 17.6% more than the public, shows research carried out by Michel Chamoun as part of his master’s degree at the Faculty of Pharmacy of the University of Montreal. A prescribed drug costs an average of $62.34 with private insurers, compared to $52.99 under the public plan.

Free sale

In 2021, the value of the total over-the-counter drug market was nearly $3.8 billion, shows data provided to The Press by the multinational health data company IQVIA. Their growth rate is, however, lower than the average: from 2019 to 2021, there is only a 2% increase in expenditure. Vitamins, analgesics (which relieve pain) and natural supplements are the ones with the largest market shares.

Political delay

In December 2021, Canada’s Minister of Health, Jean-Yves Duclos, delayed by six months the coming into force of regulations aimed at reducing the cost of patented medicines in Canada. After four postponements, its implementation is now scheduled for 1^er July 2022. First announced by Health Canada in 2019, this plan sought to protect the population from “excessive drug prices”.

Solutions

Jason Robert Guertin is aware that one cannot “put in place a program entirely covered by the public overnight”. This would be a good idea, since the establishment of a national drug purchase program would increase the bargaining power of the population with pharmaceutical companies, he argues. Mr. Guertin also suggests making greater use of biosimilars, molecules that look like biomedicines, but cost less. “Having more information on health expenditure is fundamental,” says the researcher.

Screenings

By 2023, the pan-Canadian study predicts continued growth in spending in hospitals and outpatient settings. “Cumulative spending increases by about $1 billion per year, which outstrips general market inflation,” it says. This expansion is likely due to new product approvals, higher entry prices for new drugs, and growing utilization. The group of researchers, which is already working on an update of its data, now plans to produce a report dealing with the increase in prescription drug expenditure on an annual basis.