by Angus Reid | October 30, 2019 9:30 pm
October 31, 2019 – Recent days have seen United States President Donald Trump reiterate calls for his own Health Department to speed up efforts to import prescription drugs from north of the border. This, after Trump proposed a plan to allow bulk imports from Canada earlier this year, largely unbeknownst to Canadian officials.
Experts in Canada have suggested that Trump’s proposal could put the Canadian prescription drug supply at risk and it appears that most residents agree.
Much of this anxiety may owe to the fact that many Canadians already face problems with filling their prescriptions.
Four-in-ten (40%), across all levels of income, say that they, or someone in their household, have had difficulty getting their prescriptions filled. That is, they were sent to another pharmacy, only given a portion of their prescription or told their prescription could not be filled at all.
The Angus Reid Institute (ARI) was founded in October 2014 by pollster and sociologist, Dr. Angus Reid. ARI is a national, not-for-profit, non-partisan public opinion research foundation established to advance education by commissioning, conducting and disseminating to the public accessible and impartial statistical data, research and policy analysis on economics, political science, philanthropy, public administration, domestic and international affairs and other socio-economic issues of importance to Canada and its world.
In the days and months following an unexpected announcement from U.S. President Donald Trump that his government was seeking to allow states, wholesalers and pharmacists to import medications from Canada, with approval from the Federal Drug Administration, many experts and government officials in Canada have been sounding the alarm. Government documents warn that Canadians could face drug shortages or higher prices for their prescriptions as a result, and experts in the field have suggested the same. Such a program could compound a problem that many Canadians evidently already face.
Indeed, four-in-ten Canadians (40%) say that they, or someone in their household, have had difficulties getting their prescriptions filled in recent years. These respondents have either been sent to another pharmacy, given only a portion of their prescription or told their prescription could not be filled at all.
In addition to these personal experiences, it is notable that a 2018 survey from the Canadian Pharmacists Association found that 79 per cent of Canadian pharmacists reported that drug shortages have ‘greatly increased’ in the last three to five years.
It is perhaps unsurprising then, that for close to half (46%) of those who have experienced difficulty in filling prescriptions, or who share a household with someone who has, these instances have not been isolated:
The demographic concentration of drug shortage-related issues becomes more evident when looking at age and gender splits, as well as prescription use.
First, the more prescriptions a person has, the more likely they are to have had difficulty filling said prescriptions. Those currently taking six or more prescription drugs are twice as likely (61%) to experience the issues themselves compared to those taking one or two (30%).
Notably, women of all ages are more likely to say that they have faced these difficulties, with older women (55+) most likely to have been turned away or sent elsewhere for their prescriptions:
The seriousness of this issue becomes more evident when considering the number of Canadians who consider at least one of their prescriptions to be “essential” to their well-being. Nine-in-ten Canadians with a prescription (88%) say that it is critical to their health:
Given that provincial governments oversee their own pharmacare plans, it is reasonable to expect that experiences with filling prescriptions may vary by region. Quebec, for instance, is home to a hybrid public and private pharmacare program that offers universal access to most prescription drugs. Observers continue to debate the success of that program, as experts note that this has come with increased costs compared to the rest of Canada.
Cost concerns aside, Quebec residents are least likely to have had issues with filling prescriptions, while just next-door Ontario residents have the highest rates of difficulty:
Despite the large number of Canadians who have experienced issues with filling prescriptions, most are relatively confident about their prescription drug supply. Two-thirds say that, to the best of their knowledge, they feel the current supply is sufficient, while equal numbers feel it is abundant (16%) or insufficient (17%):
A person’s experience with prescription filling frustrations appears to play a role in their evaluation of the current landscape. Three-in-ten of those who have personal experience struggling to fill a prescription (31%) say Canada has problems to deal with on this issue. Among those who have never had an issue, just 12 per cent say Canada has frequent shortages to deal with:
Canadians who are more familiar with the proposed U.S. prescription drug policy are more likely to worry about its consequences for Canada. Seven-in-ten of those who say they are at least somewhat familiar with the policy (71%) also say they are worried about the impact it may have on drug prices in this country. Overall, just under two-thirds (64%) of Canadians say they are concerned about this issue:
Age and gender are also a factor in opinions of the U.S. drug import plan. Men under the age of 55 are less likely to say that they are concerned about future shortages. Conversely, three-quarters (74%) of women ages 55 and older are worried about the policy, the highest of any age and gender group. It is worth noting that despite the different degrees of concern, at least half in every age and gender group are worried about the impact of bulk-exporting drugs to the U.S.:
For Canadian households earning less than $50,000, the proposed U.S. policy is slightly more worrisome, but it is worth noting that Canadians from all income levels voice concern about potentially higher prices, or drug shortages that may result from the U.S. government’s proposal:
Regardless of where Canadians stand on their own prescription drug policy, it would appear that most do not believe Canada has a role to play in solving the American problem. Canadians were asked which of the following statements they agree with most:
“It’s not right that Americans usually have to pay several times more than Canadians for the prescription drugs they need. We should help them if we can.”
“It is not our responsibility to help lower the cost of prescription drugs in the U.S. We should focus on making sure the domestic supply is sufficient and available to Canadians. “
Four-in-five Canadians (79%), consistently across the country, say that it is not their responsibility to help lower the cost of prescription drugs for Americans, and that our focus should be on the domestic supply. One-in-five (21%) lean the other way and say that we should help if we can. Younger Canadians are more likely to support the U.S. cause, but seven-in-ten from each age group say Canada should not worry about prices south of the border:
Running parallel to the discussion of how to handle American actions on this file is a debate about the future of Canada’s own healthcare system. Both the Liberal Party and NDP ran a campaign in the recent election promising to implement, in different ways, a national pharmacare program. The Liberal Party proposed an investment of $6 billion in order to reduce prescription drug prices and move gradually toward a universal program. The NDP plan promised to establish a full universal pharmacare program right away, which would cover the costs of commonly prescribed drugs for all Canadians. Speaking in Ottawa after meeting with his caucus this week, NDP leader Jagmeet Singh stated that the first bill his party will put forth in the coming legislative session will be designed to create a universal pharmacare system in Canada.
For their part, an overwhelming majority of Canadians (78%) said that they supported one of these pharmacare proposals, with just one-in-five (22%) saying Canada should not invest in universal coverage. Support for investment into pharmacare rises to 88 per cent among the lowest income households:
From a political perspective, it is notable that support for pharmacare among the centre-left in Canada is significant. This suggests that the Liberal minority government may find cooperation in developing legislation if it indeed wishes to push forward with the aforementioned investment. Even a majority of Conservatives (57%) support one of these pharmacare approaches:
For detailed results by age, gender, region, education, and other demographics, click here.
For detailed results from the October 15 release, click here.
For detailed results by income fine, click here.
For detailed results by prescription drug use, click here.
To read the full report, including detailed tables and methodology, click here.
Click here to read the full questionnaire used in this report.
Shachi Kurl, Executive Director: 604.908.1693 firstname.lastname@example.org @shachikurl
Dave Korzinski, Research Director: 250.899.0821 email@example.com
Source URL: http://angusreid.org/cross-border-pharma/
Copyright ©2019 Angus Reid Institute unless otherwise noted.