Why are we paying so much more for drugs than Europe?

By ANGELO PERSICHILLI

The Hill Times      Oct. 17, 2016

TORONTO—A few weeks ago, Canadian consumers rejoiced because the cost of prescription drugs in Canada were lower than in the United States. But do they know that the cost of drugs in Canada is much higher than in most of the European countries?

Laureano Leone, born in Italy, with a degree in pharmacy from the U.S., an Order of Canada, and experience as a former Ontario Liberal MPP, says that “it is unbelievable how our governments wpillsaste billions of dollars paying high prices for pharmaceuticals at the time when they close hospitals.”

The fight against “this waste” is back in time and well documented.

“In 1985, I made an analysis of the cost of drugs between Italy and Ontario. I found out that the Italian prices were 60 to 70 per cent higher,” Leone says. However, “in 2012 I wanted to see what was the situation after so many years and I found out the reversal. the Ontario prices were 60 to 70 per cent higher, and for brand name products were up to 14 times higher than Italy.”

Leone has researched widely the prices of many drugs in Europe, Canada, and United States, and has a long list properly documented and presented in alphabetic order. The first in the list is Accupril 5, from Pfizer, a drug to control blood pressure. The price per pill is 14 cents in Italy (all figures in Canadian currency), 95 cents in Canada, and $2.59 in the U.S. Also from Pfizer is Aricept 5 (dementia): it costs $1.26 in Italy, $5.25 in Canada, and $15 in the U.S. For Crestor 5 (cholesterol) from Astra, the price was 72 cents in Italy, $1.36 in Canada, and $6.72 in the U.S.

Leone says that his findings have been validated by a renowned professor of York University, Joel Lexchin, and they “show that we are losing millions of dollars every day. Still there is refusal in recognition by the political establishment.”

The loss of money is considerable, considering the increasing financial difficulties governments have to provide health assistance to their citizens.

For example, in 1997 the government of Ontario was spending 33 per cent of its operating costs on health care. In 2001, this went up to 41.8 per cent and by the 2011 it is supposed to reach 42 per cent. However, if we eliminate the one-shot expense of the bailout money to the auto industry, the medicare percentage goes up to 46 per cent. To explain the systematic health-care bailout another way, the cost of health care in Ontario in the year 2000 was $22.2-billion; in 2011, it was $47.4-billion.

The entire health budget for 2015-16 was $50.8-billion, up from $50.2-billion a year earlier. Even if that represents a hike of just 1.2 per cent, down from 2.5 per cent the year before, the financial pressure will still increase in future years. With inflation and an aging and growing population, parts of the system, especially hospitals, will continue to face pressure to do more with less. Base operating funding for Ontario’s 149 hospitals will be frozen for the fourth year in a row.

In 2015, the total health expenditure in Canada was expected to reach $219.1-billion, or $6,105 per person. It is anticipated that, overall, health spending represents 10.9 per cent of Canada’s gross domestic product (GDP).

The increased cost of pharmaceuticals, compared to other European countries, is calculated in billions of dollars, but this is not the only reason for the increasing spending for pharmaceuticals. According to a report from Ontario’s Ministry of Health, a considerable amount of prescriptions, in many cases generously prescribed by some doctors, are wasted by patients. Furthermore, the belief that more prescriptions equals better health is wrong.

David Juurlink, a drug safety expert and co-author of the report, told The Toronto Star last week that “drugs are prescribed so commonly because they are perceived to be benign. That’s not true,” and these drugs “are inherently dangerous.”

There is no doubt that the health system needs some changes to better cope with increasing demands in the future, but at the same time, we can also dispute the argument that there is not enough money to fulfill these needs. In fact, money is there but it is used to pay for overpriced pharmaceuticals and wasted by useless prescriptions that don’t cure the patients and are, in fact, in some cases even dangerous. The result is that it funnels more taxpayer money that necessary into multinationals’ coffers.

Leone provided The Hill Times with a long list of pharmaceuticals that are overpriced in Canada, and a long list of politicians, of all stripes, who he tried to approach to explain the waste of taxpayers’ money, but to no avail: “I cannot believe that this is happening in Canada when we tell the world that we wave the greatest example of democracy.”

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