High drug costs, non‑adherence challenges
The CCPA analysis highlights that in 2023, Canadian residents spent $8 billion out of pocket on prescription drugs, while $15.8 billion was paid through private insurance plans, including employer-sponsored benefits. Longhurst reports that cost-related medication non-adherence—when patients do not follow prescribed drug therapies because they cannot afford them—remains a “pressing concern” in Canada.
Estimates from 16 studies cited in the CCPA analysis suggest that between 5% and 10% of the population cannot follow medical recommendations for prescription drug therapy due to an inability to pay. Predictors of non-adherence include “high out-of-pocket spending, low income or financial flexibility, lack of drug insurance, younger age, and poorer health.” Survey evidence cited in the report indicates that “upwards of one in five people in Canada have not taken prescribed medication because it was too expensive.”
The CCPA report says research in favour of national pharmacare has remained consistent even as federal fiscal plans have changed. Longhurst notes that governmental reviews have recommended “a system of universal, publicly funded, single-payer pharmacare.” Citing the 2019 report A Prescription for Canada, he points out that by 2027, “with a comprehensive formulary of drugs, Canada would spend $5 billion less on prescription drugs while at the same time improving access for all.”
Longhurst writes that “national pharmacare can help address widening inequality and cost of living pressures, but we need the federal government to recommit to this nation-building project,” and concludes that Ottawa’s current approach “appears to be killing any hope of national pharmacare before it even got off the ground.”
Canada faces a “multiprong threat” to prescription drug affordability, driven by domestic regulatory changes, international trade dynamics and political resistance to comprehensive pharmacare, according to a previous CCPA report.