Healthy Skepticism Library item: 15120
Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.
Publication type: report
Canadian RX Atlas
Vancouver: The University of British Columbia 2008 Dec
http://www.chspr.ubc.ca/rxatlas/canada
Abstract:
Canadian governments, employers, unions, and patients currently spend more money on prescription drugs (about $20 billion in 2007) than is spent on all services provided by physicians in Canada. At the same time, prescription drug spending per capita varies by over 50% across provinces.
Surprisingly little information is systematically collected to determine which drugs account for most of the spending in Canada, what factors drive interprovincial variations in spending, and whether population age is an important cause of spending variations across provinces and trends over time.
The 2nd edition of The Canadian Rx Atlas significantly enhances our understanding of medicine use by providing the first-ever portrait of age-specific patterns of prescription drug use and costs across provinces. It breaks down nearly $20 billion in prescription drug spending (private and public) and provides a comprehensive portrait of the factors that drive trends over time and variations across provinces.
KEY FINDINGS
TOTAL SPENDING
In 2007, Canadians spent $578 per capita on retail purchases of prescription drugs, approximately $19 billion in total
Per capita spending on prescription drugs varied across provinces from $432 in British Columbia to $681 in Quebec
Twenty-five percent of Canadian spending on prescriptions in 2007 was for cardiovascular drugs
SPENDING BY POPULATION AGE
On average, spending on prescriptions for Canadians age 65 and older was more than twice that of Canadians aged 45–64 and over six times that of Canadians aged 20–44
The large cohort of persons aged 45–64 (including the “baby boomersâ€) accounted for 36% of all Canadian retail spending on prescription drugs in 2007
SOURCES OF INTERPROVINCIAL VARIATION
Adjusting for population age explained some, but far from all, of the interprovincial variation in per capita prescription drug spending in 2007
Age-standardized spending per capita varied by over 55% across provinces, from $418 in British Columbia to $655 in Quebec
Most interprovincial variations in age-standardized prescription drug spending per capita stemmed from variations in the volume of drugs purchased
OVERALL COST IMPACT OF VARIATIONS
If all cost-drivers in Quebec were the same as the national average on an age-standardized basis, total spending on prescription drugs in that province would be $595 million lower than was actually the case in 2007
If all cost-drivers in British Columbia were the same as the national average on an age-standardized basis, total spending on prescription drugs in that province would be $701 million higher than was the case in 2007
POTENTIAL EXPLANATIONS FOR VARIATIONS
Differences in the number of drugs covered by provincial drug plans do not appear to explain interprovincial variations in prescription drug spending
Population characteristics such as socioeconomics, health status, and health system do not point to clear explanations of interprovincial variations in age-standardized spending
TRENDS OVER TIME
Retail spending on prescription drugs per Canadian nearly doubled between 1998 and 2007, even after adjusting for the effects of general inflation on the value of a dollar
Spending grew most rapidly in Manitoba, which began 29% below the national average in 1998. Quebec had the second fastest growth rate, but began with spending 7% above the national average in 1998
Population aging had modest effects on growth in retail spending on prescription drugs in all provinces between 1998 and 2007
Increased volume of prescription drugs purchased and increased use of more costly therapeutic choices drove most of the spending growth observed between 1998 and 2007
