Written by Faculty of Medicine
Costs for prescription drugs in the largest categories of primary care medicines varied by more than 600 per cent among 10 high-income countries with universal health care, according to joint research by the School of Population and Public Health and Harvard Medical School.
The study, published in the CMAJ, looked at data on the volume and daily cost of primary care prescriptions in 10 high-income countries with universal health care: Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland and the United Kingdom. Because of the high cost of pharmaceutical drugs and the lack of universal health care, the United States was not included.
Researchers focused on six categories of widely used primary care drugs usually purchased at retail pharmacies rather than hospital pharmacies. These included hypertension treatments, pain medications (nonsteroidal anti-inflammatory drugs as well as opioids), cholesterol-lowering drugs, noninsulin diabetes treatments, gastrointestinal medications and antidepressants. They measured frequency of use of the medications by average number of days of therapy purchased per capita.
Medications for treating high blood pressure accounted for the largest number of days of therapy in all countries.
All countries except Canada offered universal coverage of outpatient prescription drugs. In the five countries with universal, single-payer coverage of prescription drugs, the average per-person cost was $77. In the four countries with universal social insurance for prescription drugs, average costs were $99, and in Canada, which has a mixed system of private and public financing, the average costs were $158.
Higher costs of drugs and the mix of therapies chosen accounted for most of the cost differences between countries.
“The volume of therapy purchased in Canada was about the same as that in the comparator countries; however, Canadians spent an estimated $2.3 billion more than they would have in 2015 if these primary care treatments had had the same average cost per day in Canada as in the nine comparator countries combined,” writes lead author Steven Morgan, a Professor in the School of Population and Public Health.
“Average expenditures are lower among single-payer financing systems, which appear to promote lower prices and selection of lower-cost treatment options within therapeutic categories,” the study authors conclude.