If you belong to a group or individual health benefits plan, you may have coverage for prescription drugs. But you may not be covered for the full cost. And with the high price of some of today’s wonder drugs, your share of the bill can add up.
A recent report from the government’s advisory council on national pharmacare revealed just how pricey it can get. The report said nearly three million Canadians couldn’t afford one or more prescription drugs in the past year. What’s more, one million Canadians are cutting back on food or home heating just to pay for their meds.
And it’s not just the cost of prescriptions to consider. There’s also the after-effects of not being able to afford to take medication. For example, you’re more likely to be admitted to the hospital if you don’t get proper treatment. The report highlighted a recent study looking at what would happen if Canadians didn’t have to pay for medications for just three diseases. The big three included diabetes, heart disease and chronic respiratory conditions. The result: 220,000 fewer visits to emergency rooms and 90,000 fewer hospitalizations annually. That’s a potential saving of up to $1.2 billion a year.
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Canada drug coverage advisory group recommends new pharmacare plan
To bring down prescription costs, the advisory council has called for a universal, single-payer, national pharmacare system. Wondering what this may mean for you and your wallet if the government acts on these recommendations? Here’s the gist:
- What’s covered? A new drug agency would create a list of prescription medicines that pharmacare would cover. This list would start with common or essential medicines for most major conditions, and expand over time.
- How much will you have to pay? The council recommends a $2-per-prescription co-payment for essential medicines. All other others drugs on the list would cost $5 per prescription. There will also be an annual limit of $100 per household. Low-income seniors, people living with disabilities or on social assistance may be exempt from these payments.
- When will it happen? The council hopes to have the first stage of pharmacare with this initial list in action by Jan. 1, 2022. Once in effect, the council predicts pharmacare will cut Canada’s spending on prescription drugs by $5 billion a year.
- What about coverage for less-common diseases? The government also intends to create a strategy to help Canadians access high-cost drugs for rare diseases by 2022. It plans to invest up to $500 million a year on this strategy.
It’ll take a few years to see if this plan takes effect. So what can you do to save more and pay less on prescription drugs in the meantime? Here are five suggestions to keep in mind:
1. Know your pharmacy options
Pharmacies charge dispensing fees to help cover the cost of filling the prescription and discussing your treatment with you. They’re required to post the amount they charge. The difference among dispensing fees and services provided among pharmacies may surprise you.
2. Buy generic drugs
A generic drug is clinically identical to the brand-name product. It has the same active ingredients, but can cost considerably less. According to Health Canada, nearly half of all prescriptions filled by pharmacies today use generic drugs. Plus, some hospitals prescribe generic drugs almost exclusively. The quality standards for brand-name drugs and generic drugs are the same. Some company plans automatically switch you to a generic drug when such a choice is available. Or, they’ll only cover you for the cost of the generic equivalent.
3. Get a longer supply of medications for chronic conditions
Pharmacists can dispense a longer supply of drugs for chronic or lifelong conditions for a single dispensing fee. So ask your doctor if it’s possible for you to get a longer prescription.
4. Ask your doctor for prescription samples
Has your doctor suggested you try out a new medication? Ask if the manufacturer has given the doctor any free samples.
5. Review your medications regularly
As part of your regular visits, ask your doctor and pharmacist to re-evaluate your medications. It’s a great way to make sure they’re all working as planned. You can also determine whether you still need to take them all. Don’t stop taking a prescription medicine without consulting your physician.
Perhaps you may not approach buying prescription drugs in the same way as you think about groceries or clothing. But it still pays to be a smart consumer.