title: Estimated cost of universal public coverage of prescription drugs in Canada.
abstract: BACKGROUND
  With the exception of Canada, all countries with universal health insurance systems provide universal coverage of prescription drugs. Progress toward universal public drug coverage in Canada has been slow, in part because of concerns about the potential costs. We sought to estimate the cost of implementing universal public coverage of prescription drugs in Canada.
  
  
  METHODS
  We used published data on prescribing patterns and costs by drug type, as well as source of funding (i.e., private drug plans, public drug plans and out-of-pocket expenses), in each province to estimate the cost of universal public coverage of prescription drugs from the perspectives of government, private payers and society as a whole. We estimated the cost of universal public drug coverage based on its anticipated effects on the volume of prescriptions filled, products selected and prices paid. We selected these parameters based on current policies and practices seen either in a Canadian province or in an international comparator.
  
  
  RESULTS
  Universal public drug coverage would reduce total spending on prescription drugs in Canada by $7.3 billion (worst-case scenario $4.2 billion, best-case scenario $9.4 billion). The private sector would save $8.2 billion (worst-case scenario $6.6 billion, best-case scenario $9.6 billion), whereas costs to government would increase by about $1.0 billion (worst-case scenario $5.4 billion net increase, best-case scenario $2.9 billion net savings). Most of the projected increase in government costs would arise from a small number of drug classes.
  
  
  CONCLUSIONS
  The long-term barrier to the implementation of universal pharmacare owing to its perceived costs appears to be unjustified. Universal public drug coverage would likely yield substantial savings to the private sector with comparatively little increase in costs to government.
authors.affiliation: School of Population and Public Health (Morgan); Centre for Health Services and Policy Research (Law), University of British Columbia, Vancouver, BC; Harvard PhD Program in Health Policy (Daw), Harvard University, Cambridge, Mass.; Faculty of Medicine (Abraham), University of Toronto; Women's College Hospital, and Department of Family and Community Medicine (Martin), University of Toronto, Toronto, Ont. steve.morgan@ubc.ca.
authors.forename: Steven G
authors.initials: SG
authors.lastname: Morgan
authors.affiliation: School of Population and Public Health (Morgan); Centre for Health Services and Policy Research (Law), University of British Columbia, Vancouver, BC; Harvard PhD Program in Health Policy (Daw), Harvard University, Cambridge, Mass.; Faculty of Medicine (Abraham), University of Toronto; Women's College Hospital, and Department of Family and Community Medicine (Martin), University of Toronto, Toronto, Ont.
authors.forename: Michael
authors.initials: M
authors.lastname: Law
authors.affiliation: School of Population and Public Health (Morgan); Centre for Health Services and Policy Research (Law), University of British Columbia, Vancouver, BC; Harvard PhD Program in Health Policy (Daw), Harvard University, Cambridge, Mass.; Faculty of Medicine (Abraham), University of Toronto; Women's College Hospital, and Department of Family and Community Medicine (Martin), University of Toronto, Toronto, Ont.
authors.forename: Jamie R
authors.initials: JR
authors.lastname: Daw
authors.affiliation: School of Population and Public Health (Morgan); Centre for Health Services and Policy Research (Law), University of British Columbia, Vancouver, BC; Harvard PhD Program in Health Policy (Daw), Harvard University, Cambridge, Mass.; Faculty of Medicine (Abraham), University of Toronto; Women's College Hospital, and Department of Family and Community Medicine (Martin), University of Toronto, Toronto, Ont.
authors.forename: Liza
authors.initials: L
authors.lastname: Abraham
authors.affiliation: School of Population and Public Health (Morgan); Centre for Health Services and Policy Research (Law), University of British Columbia, Vancouver, BC; Harvard PhD Program in Health Policy (Daw), Harvard University, Cambridge, Mass.; Faculty of Medicine (Abraham), University of Toronto; Women's College Hospital, and Department of Family and Community Medicine (Martin), University of Toronto, Toronto, Ont.
authors.forename: Danielle
authors.initials: D
authors.lastname: Martin
mesh_terms: D002170:Canada; D017046:Cost Savings; D017281:Cost of Illness; D003365:Costs and Cost Analysis; D004358:Drug Therapy / Q000191:economics*; D006801:Humans; D007356:Insurance, Pharmaceutical Services / Q000191:economics*; D055553:Prescription Drugs / Q000191:economics*; D017149:Private Sector / Q000191:economics; D019472:Universal Health Insurance / Q000191:economics*
chemical_list: D055553:Prescription Drugs