E-DRUG: patient copayments in Canada and Italy (2)
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Hello from Canada:
At this point every Canadian province has a deductible and/or a
copayment as part of its drug plan. In some cases, such as
Saskatchewan the deductible is so high, $850 per 6 months, that
most people do not receive any benefits from the plan. (The
deductible is much lower for seniors and people on welfare.) =
Here in Ontario there was a recently completed study that showed
that the imposition of a $2 per prescription copayment has caused
a drop of about 8-9% in the number of psychiatric drug
prescriptions, but there was no attempt to determine if health
status has suffered as a result. (The copayment started about
one year ago.) In Nova Scotia, they have moved to an insurance
model for the provincial drug plan, i.e., you have to pay a
premium if you want to be covered. If you don't pay the premium
then you are not part of the plan. In Quebec, the plan has been
expanded to cover the part of the population that previously did
not have either public or private insurance. However, this was
accomplished by increasing the deductible and copayment on
everybody else in the public plan so as a result seniors and
welfare recipients are now paying more for their drugs. For a
short while even drugs for tuberculosis were subject to a
copayment, but there was a large protest about this and now t.b.
drugs are free.
In Ontario, there was a lot of initial protest, mostly from
seniors groups, about the copayment but not much has happened
since. Doctors and pharmacists, by and large, did not have too
much to say about the copayment, although in some areas the
pharmacists are waving the copayment.