British Columbia has by far the highest rate in the country of patients who stop taking prescribed drugs because they can't afford them, according to a study published Monday in the Canadian Medical Association Journal.
The study found that one in six B.C. residents (17 per cent) did not adhere to their prescriptions because of cost, a rate nearly twice the national average of 9.6 per cent.
Only B.C. and the Atlantic provinces at 11.9 per cent had non-compliance rates above the national average. Quebec had the country's lowest prevalence of residents unable to pay for their prescription drugs at 7.2 per cent, while Ontario's rate was 9.1.
Researchers were surprised to find such a large difference between non-compliance in B.C. and the rest of the country, said study co-author Michael Law of the Centre for Health Services and Policy Research at the University of British Columbia.
Mr. Law suggested that the gap could result from the struggle B.C. residents have making ends meet in a province with such a high cost of living. "People may be having more difficulty trading off those other costs in life, like housing, against those costs of life that come from prescription drugs," he said.
The study pointed to B.C.'s "high deductible public drug plan" as another possible reason.
Mr. Law said the findings are a wakeup call to health authorities, since patient failures to follow through on their prescriptions often lead to higher costs later on.
"Prescription drugs are potentially a substitute for other types of care, They have an impact on people's health," Mr. Law said. "If people can't afford to take a drug that will improve their health, or even potentially lengthen their life, then that has consequences."
For instance, a drug taken properly that prevents a stroke or heart attack averts an additional expense that medicare will not have to bear, he said.
The data was based on interviews with more than 5,700 participants in a Statistics Canada survey on community health in 2007.
A large number of those who reported skipping doses, not filling or failing to refill prescriptions for cost reasons were not covered by a drug plan, according to the CMAJ study.
Health Minister Mike de Jong said he was somewhat taken aback by B.C.'s poor compliance rate, noting that more than 200,000 low-income families pay nothing for their prescription drugs.
But he vowed to take a closer look at why the province's rate was the worst in Canada. "When a journal like the CMAJ publishes a report, it's important to give it serious consideration," Mr. de Jong said. "It's worth investigating."
NDP Leader Adrian Dix blamed the government for ladling extra costs on middle-income earners, making it difficult for them to afford the rising price of prescription drugs.
"If you're earning $40,000 a year in this city, and you've just had your [health-care]premiums go up 18 per cent for the third straight time, transit fares are going up, hydro rates going up, along with housing prices, then you are forced into these very difficult choices," Mr. Dix said. "British Columbians have been facing the brunt of a government that has been dumping costs on middle-income people."
The NDP Leader also blamed the Liberal government for not being tough enough on pharmaceutical companies to bring down the price of prescription drugs. "Quite frankly, they have not been protecting public health care and patients against the desire of the drug industry to make outrageous profits."
Mr. Law, meanwhile, said the number of Canadians unable to afford prescription drugs points to the need for some form of national drug plan.
"We have focused only on catastrophic drug costs, but that overlooks the fact a lot of people have trouble with just their day-to-day drug coverage costs," he said. "There are people who can't afford $10 or $20 for prescription drugs, because they're living paycheque to paycheque, and for them, that's just too much."