There is a complex arrangement of publicly funded drug coverage programs, which creates uneven access to prescription drugs. Each of these models have limitations, particularly for low income earners who do not meet the income thresholds of targeted coverage plans. The universal pharmacare model does not exist in Canada, however, it is widely recognized as providing greater access to prescription medications and has the potential to reduce health inequities for the growing number of Toronto residents living in poverty and experiencing poor health. It also reduces the cost of medications through increased bulk buying.
This report explores how the drug coverage programs in Canada create barriers to accessing prescription drugs for individuals and families who participate in Toronto Public Health programs. These case studies clearly illustrate that the most equitable model is the universal program which provides medications for little or no out-of-pocket cost. Other countries that provide universal drug coverage pay less for medications than Canada and have lower rates of non-adherence due to cost.
Findings from this report, jointly authored by Wellesley Institute and Toronto Public Health, support the implementation of a universal single-payer pharmacare program at the federal level, and create a rationale to further extend drug coverage to all residents in the province as an interim measure. Such actions would help to reduce health inequities and improve the health of the whole population through ensuring universal and equitable access to prescription medications.