Measuring equity in access to pharmaceuticals

Canadians spend about $27 billion each year on pharmaceuticals, which represents the largest component of private health care costs. For some, this means significant financial hardship. For others, the costs are too high, prohibiting access to necessary care. To date, very little attention has been paid to equity in access to prescription drugs, even though a central goal of Canadian health care policy is to promote access to necessary health care. British Columbia’s Pharmacare program of income-based drug coverage has been proposed as a national standard. Gillian Hanley is examining the degree of income-related inequity in accessing prescription drugs, before and after the program was introduced in 2003, to assess the potential impact of national implementation. She is looking at how a change in coverage affects equity of access to medicines at a population level as well as within and across population subgroups. Previous research by Hanley and her colleagues has shown that the major impact of BC’s Pharmacare program is one of redistributing costs from public to private sources and across various income levels. Part of this research suggested that individuals of higher income generally have higher total drug expenditures. As previous research has shown that higher income individuals are often healthier than those of lower income, their higher drug spending is unexpected and warrants further examination. . Her goals are to offer policy makers insight into how to improve current Pharmacare models and to provide researchers with new methods to examine equity in access to medicines and health services.