PHARMACARE: Cost-related nonadherence to medications and pharmacare

Abstract

Canada is the only developed country with a universal healthcare system that does not cover prescription medication outside the hospital setting (Morgan, Martin, Gagnon, Mintzes, Daw & Lexchin, 2015). Canadians pay for their prescription medications either through private insurance programs or out of pocket (O’Grady, n.d.; Statistics Canada, 2016). As well, many private insurance programs pay a fixed price or percentage, which may still leave people with high out-of-pocket costs (Luiza et al., 2015); especially those needing cancer symptom management medications. Some people, including patients with cancer, report not filling prescription medications, not renewing medications or skipping doses to make the prescription last longer due to financial barriers (Angus Reid Institute, 2015; Briesacher, Gurwitz, & Soumerai, 2007). This can be defined as cost-related nonadherence, a common issue in Canada. In fact, one in 10 Canadians experience cost-related nonadherence (Morgan et al., 2015). Nonadherence to prescription medications is related to poorer health outcomes and an increased use of the healthcare system (Morgan & Lee, 2017). This paper will discuss the current policies and programs for pharmacare in Ontario, and propose solutions that oncology nurses can use to address cost-related nonadherence.