Chronic Catastrophes: Exploring the concentration and sustained nature of ambulatory prescription drug expenditures in the population of British Columbia, Canada

Gillian E. Hanley, Steve Morgan
Research Summary: 

Purpose of Study:

The purpose of this study was to examine if income-based drug insurance policies provide adequate coverage for high-cost prescription drug users.
Research Approach/Method: The authors performed data analysis using a cohort study design to examine population prescription drug use, focusing on high-cost users.

Key Overarching Message:

Results suggest that high-cost users are typically old, sick, and poor. These users experience sustained periods of elevated pharmaceutical drug use. Canadaís drug insurance policies must reflect the financial burdens imposed by current high deductibles and user charges.

Key Findings:

Canadian federal and provincial drug insurance policies assume that elevated drug use occurs in acute episodes. However, federal and provincial drug insurance policies may not provide adequate coverage for high-cost users. Prescription drug spending is highly concentrated among a relatively small portion of the population with very poor health status and high needs for treatment. Only 5% of BCís population is responsible for almost 50% of prescription drug spending. Individuals continue to spend the same amount of money on drugs over time. Of the high cost pharmaceutical users in 2001, 80% still had high needs in 2004.