Purpose of Study
The purpose of this study was to examine the causes of prescription drug spending across Canadian provinces.
The authors linked unique databases, and yielded province-specific estimates of prescription drug use and spending across population age groups.
Key Overarching Message
Results suggest that interprovincial variation in drug spending is driven neither by differences in population age nor by provincial drug plan formularies. Observed differences are also not likely due to differences in health system characteristics.
Differences in population age are often assumed to cause interprovincial variation in drug spending. In fact, spending on prescription drugs varies widely across provinces even after taking into account differences in population age. Residents of any given age in some provinces take more prescription drugs and, when they do, they take more expensive ones than residents of the same age in other provinces. These are the central causes for interprovincial variation in spending. Interprovincial differences in prescription drug use are not influenced by provincial drug plan formularies. Non-medical causes, such as patient expectations and physician prescribing practices, may be the source of regional differences in spending.