Research Project

Project Publication

Atlas Fast Facts

Data Source: IMS Health, CIHI, Statistics Canada
Population Studied: All Canadian residents
Population Size: Approx. 32 million
Period: 1998 to 2007
Specific Regions: National and all provinces
Statistical Methods: Index-theoretic

Research Areas

Canadian Rx Atlas, 2nd Edition (2008)

Canadian governments, employers, unions, and patients currently spend more money on prescription drugs (about $20 billion in 2007) than is spent on all services provided by physicians in Canada. At the same time, prescription drug spending per capita varies by over 50% across provinces.

Surprisingly little information is systematically collected to determine which drugs account for most of the spending in Canada, what factors drive interprovincial variations in spending, and whether population age is an important cause of spending variations across provinces and trends over time.

The 2nd edition of The Canadian Rx Atlas significantly enhances our understanding of medicine use by providing the first-ever portrait of age-specific patterns of prescription drug use and costs across provinces. It breaks down nearly $20 billion in prescription drug spending (private and public) and provides a comprehensive portrait of the factors that drive trends over time and variations across provinces.

Key Findings

Total spending

  • In 2007, Canadians spent $578 per capita on retail purchases of prescription drugs, approximately $19 billion in total
  • Per capita spending on prescription drugs varied across provinces from $432 in British Columbia to $681 in Quebec
  • Twenty-five percent of Canadian spending on prescriptions in 2007 was for cardiovascular drugs

Spending by population age

  • On average, spending on prescriptions for Canadians age 65 and older was more than twice that of Canadians aged 45–64 and over six times that of Canadians aged 20–44
  • The large cohort of persons aged 45–64 (including the “baby boomers”) accounted for 36% of all Canadian retail spending on prescription drugs in 2007

Sources of interprovincial variation

  • Adjusting for population age explained some, but far from all, of the interprovincial variation in per capita prescription drug spending in 2007
  • Age-standardized spending per capita varied by over 55% across provinces, from $418 in British Columbia to $655 in Quebec
  • Most interprovincial variations in age-standardized prescription drug spending per capita stemmed from variations in the volume of drugs purchased

Overall cost impact of variations

  • If all cost-drivers in Quebec were the same as the national average on an age-standardized basis, total spending on prescription drugs in that province would be $595 million lower than was actually the case in 2007
  • If all cost-drivers in British Columbia were the same as the national average on an age-standardized basis, total spending on prescription drugs in that province would be $701 million higher than was the case in 2007

Potential explanations for variations

  • Differences in the number of drugs covered by provincial drug plans do not appear to explain interprovincial variations in prescription drug spending
  • Population characteristics such as socioeconomics, health status, and health system do not point to clear explanations of interprovincial variations in age-standardized spending

Trends over time

  • Retail spending on prescription drugs per Canadian nearly doubled between 1998 and 2007, even after adjusting for the effects of general inflation on the value of a dollar
  • Spending grew most rapidly in Manitoba, which began 29% below the national average in 1998. Quebec had the second fastest growth rate, but began with spending 7% above the national average in 1998
  • Population aging had modest effects on growth in retail spending on prescription drugs in all provinces between 1998 and 2007
  • Increased volume of prescription drugs purchased and increased use of more costly therapeutic choices drove most of the spending growth observed between 1998 and 2007

Link to download: Canadian Rx Atlas, 2nd Edition (Dec 2008)

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