Quebec's drug-insurance plan 'obsolete', costly, study says

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A review by a Quebec think tank of the province’s 20-year-old drug-insurance plan concludes the public/private policy is obsolete and forcing users to pay dramatically higher prices for medication available elsewhere for much less.

“The system in place favours intermediaries who profit from the system at everyone else’s expense,” Carlton University professor and review co-author Marc-André Gagnon said in a study published Friday by the Institut de recherche et d’informations socio-économiques.

“The case of Lipitor, one of the most commonly sold medications (used to treat cholesterol levels) is one of the most revealing examples of a system of institutionalized waste.

“Even though it costs $44 to procure 500 20 mg tablets in the United States, one would have to spend $204 in Quebec to obtain the same quantity. While the retail cost is lower in Canada, you have to add $375 in delivery charges demanded from Quebec by intermediaries – five times more than in the rest of the country.”

Gagnon contends the same disparities occurred when the review examined generic drugs, with intermediaries in the purchase and distribution chain realizing markups of 89 per cent.

The review contends that per capita spending on medications in Quebec is 20 per cent higher than in the rest of the country and 80 per cent higher than the average in the other 34 countries that are members of the Organisation for Economic Co-operation and Development. Meanwhile, access to those medications in Quebec is far more difficult than in jurisdictions with fully public drug-insurance plans.

While noting that Quebec Health Minister Gaétan Barrette had obtained discounts from generic-drug manufacturers earlier this year, the authors of the review argue savings would be 12 times greater – $3.8 billion – were the drug-insurance plan to be fully public.