Prescription drug coverage in Canada: a review of the economic, policy and political considerations for universal pharmacare

Southern Med Review

Steven G. Morgan^3^2,24  Brenna Shearer^2^1,17,175  Jaden Brandt^1^2,29,290 

[1]Department of Pathology and Veterinary Clinics^347

[2]Department of Pharmaceutical Technology^350

[3]Department of Pharmacy and Pharmaceutical Administration^338

[4]Federal University of Rio de Janeiro^344

[5]Fluminense Federal University^340

[6]Institute of Biomedical Sciences^343

[7]Niterói - RJ, Brazil. Find articles by Sabrina Calil Elias^355

[8]Niterói - RJ, Brazil^341

[9]Queen's University, Centre for Health Services and Policy Research^285

[10]Queen’s University, School of Geography and Urban and Regional Planning^283

[11]Rio de Janeiro, RJ, Brazil^345

[12]School of Pharmacy^339

[13]School of Veterinary Medicine^348

[14]Scientific Directorship^352

[15]Vital Brazil Institute^353

[16]Abertawe Bro Morgannwg University Health Board^216

[17]Academic Medical Centre^279

[18]Academic and Community Emergency Specialists^239

[19]Aerodyne Research Inc, Billerica, MA 01821, USA^23

[20]Albert Schweitzer Hospital^268

[21]Amphia Hospital^267

[22]Atmospheric Turbulence and Diffusion Division, ARL, National Oceanic and Atmospheric Administration, Oak Ridge, USA^66

[23]Banner-University Medical Center South, Pharmacy Department, Tucson, USA^373

[24]Beilun Bureau of Meteorology, Ningbo 315800, China^3

[25]Biotherium^354

[26]British Geological Survey, Environmental Science Centre, Keyworth, Nottingham NG12 5GG, UK^94

[27]Broad Institute, United States^148

[28]Brock University^260

[29]Brookhaven National Laboratory, Upton, NY, USA^18

[30]Buenos Aires, Buenos Aires, Argentina^200

[31]CAS Center for Excellence in Regional Atmospheric Environment, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen, 361000, Fujian, China^29

[32]CASP, West Building, Madingley Rise, Madingley Road, CB3 0UD, Cambridge, UK^38

[33]Centers for Disease Control and Prevention, Atlanta, USA^108

[34]Centre for Agriculture and Biosciences International, UK^183

[35]Centre for Health Policy and Implementation Research, University of Health and Allied Sciences, Ho, Ghana^389

[36]Centro Científico Tecnológico La Plata, Buenos Aires, Argentina^160

[37]Centro Universitário Christus, Fortaleza, Brazil^322

[38]Centro Universitário de Anápolis, UniEvangélica, Anápolis, Brasil^297

[39]Charles University, Prague, Czech Republic^204

[40]China Center for Disease Control and Prevention, Beijing, China^110

[41]Chronic Kidney Disease Resource Centre, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Malaysia^360

[42]Cleveland State University^235

[43]Cold Regions Research Centre, Wilfrid Laurier University, Waterloo, Ontario, Canada^52

[44]Collaborative Innovation Center on Forecast and Evaluation of Meteorological Disasters, Nanjing University of Information Science & Technology, Nanjing 210044, China^4

[45]College of Health Professions^228

[46]College of Pharmacy, Anhui Medical University, 81 Meishan Road, Hefei 230032, China^30

[47]College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada^396

[48]College of Pharmacy^230

[49]Complejo Hospitalario Universitario A Coruña, La Coruña, Spain^167

[50]Consejo Nacional de Ciencia Y Tecnología, Zacatecas, México^192

[51]Conselho Nacional de Desenvolvimento Científico e Tecnológico, Brazil^312

[52]Critical Care^256

[53]Czech University of Life Sciences, Faculty of Environmental Sciences, Prague, Czech Republic^44

[54]Delegación Territorial de AEMET (Spanish National Meteorological Agency) en Aragon, Zaragoza, Spain^75

[55]Department of Anesthesia^254

[56]Department of Animal Ecology & Systematics, Justus Liebig University, Heinrich-Buff-Ring 26–32 IFZ, 35392 Giessen, Germany^35

[57]Department of Atmospheric Sciences and Department of Chemistry, Texas A&M University, College Station, TX 77843, USA^21

[58]Department of Chemistry and Cooperative Institute for Research in Environmental Sciences, University of Colorado, Boulder, CO, USA^9

[59]Department of Child and Adolescent Psychiatry^226

[60]Department of Civil and Environmental Engineering, Imperial College London, London, UK^63

[61]Department of Civil and Environmental Engineering, University of California, Berkeley, Berkeley, CA, USA^12

[62]Department of Civil and Environmental Engineering, University of Waterloo, Waterloo, Ontario, Canada^56

[63]Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone^358

[64]Department of Clinical and Health Psychology^219

[65]Department of Earth Sciences, Western University, London, Ontario, Canada^61

[66]Department of Earth and Planetary Sciences, Harvard University, Cambridge, MA, USA^20

[67]Department of Environment, Water and Natural Resources, Government of South Australia, Adelaide, SA 5000, Australia^101

[68]Department of Environmental Science, Policy, and Management, University of California, Berkeley, CA, USA^11

[69]Department of Environmental Sciences, Universidade Federal de São Paulo, Diadema, São Paulo, Brazil^8

[70]Department of Geography, University of Guelph, Guelph, Ontario, Canada^53

[71]Department of Geography, University of Innsbruck, Innsbruck, Austria^95

[72]Department of Geography, University of Lethbridge, Lethbridge, Alberta, Canada^55

[73]Department of Geology, Faculty of Geology and Geophysics, University of Bucharest, Bălcescu Bd. 1, 010041 Bucharest, Romania^37

[74]Department of Geology, University of Namur, Rue de Bruxelles 61, 5000 Namur, Belgium^93

[75]Department of Geoscience, University of Calgary, Calgary, Alberta, Canada^57

[76]Department of Geosciences and Engineering, Delft University of Technology, Stevinweg 1, 2628 CN Delft, the Netherlands^41

[77]Department of Geosciences, University of Oslo, P.O. Box 1022 Blindern, 0315 Oslo, Norway^84

[78]Department of Health Policy and Health Economics, Eötvös Loránd University, Budapest, Hungary^370

[79]Department of Hydrology and Atmospheric Sciences, University of Arizona, Tucson, AZ, USA^46

[80]Department of Medicine^261

[81]Department of Pharmaceutical Sciences, College of Health Sciences, Public Authority for Applied Education and Training PAAET, Kuwait City, Kuwait^366

[82]Department of Pharmacology and Applied Therapeutics, Faculty of Pharmacy, Kuwait University, Kuwait City, Kuwait^367

[83]Department of Pharmacology, Faculty of Basic Medical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone^356

[84]Department of Pharmacy Practice, Faculty of Pharmacy, Kuwait University, Kuwait City, Kuwait^368

[85]Department of Pharmacy, Quaid-i-Azam University, Islamabad, Pakistan^361

[86]Department of Pharmacy^232

[87]Department of Psychiatry^262

[88]Department of Quality and Patient Safety^253

[89]Department of Radiation Oncology^217

[90]Department of Renewable Resources, University of Alberta, Edmonton, Alberta, Canada^58

[91]Department of Statistics, University of Innsbruck, Innsbruck, Austria^106

[92]Department of Statistics^247

[93]Dipartimento di Ingegneria Civile, Ambientale e Architettura, Università di Cagliari, Cagliari, Italy^80

[94]Dipartimento di Matematica e Informatica, Università di Cagliari, Cagliari, Italy^81

[95]Direction Home Area Agency on Aging and Disabilities^246

[96]Director Pan-African Treatment Access Movement (PATAM), 4th floor Livingstone House, Harare, Zimbabwe^394

[97]Director of Health Services, Social Welfare and Nutrition Services, President’s Office of Regional Administration and Local Government, Dodoma, Tanzania^384

[98]Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia^359

[99]Division for Biomedical Physics, Medical University of Innsbruck, Innsbruck, Austria^105

[100]Division of Geological and Planetary Sciences, California Institute of Technology, Pasadena, CA 91125, USA^25

[101]Duke University Health System^213

[102]Duke University School of Medicine, Durham, USA^156

[103]Duke University, Durham, USA^151

[104]Dép. Biologie, Chimie et Géographie, groupe BOREAS and Québec-Océan, Université du Québec à Rimouski, 300 allée des ursulines, Rimouski, Qc, G5L 3A1, Canada^88

[105]Département de Géographie and Centre d'études nordiques, Université de Montréal, Montréal, Quebec, Canada^62

[106]ENVEO IT GmbH, Innsbruck, Austria^98

[107]EPOC, UMR 5805, Université de Bordeaux, Allée Geoffroy Saint-Hilaire, 33615 Pessac, France^85

[108]Embrapa Gado de Corte, Campo Grande, Brasil^292

[109]Embrapa Gado de Leite, Juiz de Fora, Brasil^291

[110]Emergency Medicine^238

[111]Endocrinology Department^223

[112]Environment Research Institute, Shandong University, Qingdao 266237, China^24

[113]Environment and Climate Change Canada, Saskatoon, Canada^73

[114]Environment and Climate Change Canada, Toronto, Canada^67

[115]Environment and Climate Change Canada, Victoria, Canada^74

[116]Environmental Molecular Sciences Laboratory, Pacific Northwest National Laboratory, Richland, WA, USA^19

[117]Environmental and Climate Sciences Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA^6

[118]Epidemiology and Global Health Unit, Umeå University, Umeå, Sweden^387

[119]Erasmus Medical Centre^269

[120]Faculty of Pharmacy and Health Sciences, University of Balochistan, Quetta, Pakistan^363

[121]Faculty of Physics and Electrical Engineering, University of Bremen, Bremen, Germany^50

[122]Family Medicine^248

[123]Family and Community Medicine^241

[124]Flinders University Faculty of Medicine, School of Health Sciences^250

[125]Fundação Hospitalar do Estado de Minas Gerais, Belo Horizonte, Brazil^304

[126]Fundação Municipal de Saúde de Teresina, Teresina, Brasil^211

[127]Fundação Oswaldo Cruz, Belo Horizonte, Brazil^305

[128]Fundação Oswaldo Cruz, Curitiba, Brasil^208

[129]Fundação Oswaldo Cruz, Manaus, Brasil^123

[130]Fundação Oswaldo Cruz, Recife, Brasil^286

[131]Fundação Oswaldo Cruz, Rio de Janeiro, Brasil^207

[132]Fundação Oswaldo Cruz-Fiocruz, Belo Horizonte, Brasil^127

[133]Fundação Oswaldo Cruz-Fiocruz, Curitiba, Brasil^300

[134]Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Rio de Janeiro, Brazil^311

[135]Fundação Oswaldo Cruz-Fiocruz, Manaus, Brasil^182

[136]Fundação Oswaldo Cruz-Fiocruz, Porto Velho, Brasil^168

[137]Fundação Oswaldo Cruz-Fiocruz, Recife, Brasil^197

[138]Fundação Oswaldo Cruz-Fiocruz, Rio de Janeiro, Brasil^113

[139]Fundação Oswaldo Cruz-Fiocruz, Rio de Janeiro, Brazil^306

[140]Fundação Oswaldo Cruz-Fiocruz, Salvador, Brasil^139

[141]Fundação Oswaldo Cruz-Fiocruz-Fiocruz, Manaus, Brasil^172

[142]Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Brasil^115

[143]GET-GRGS, UMR 5563, CNRS/IRD/UPS, Observatoire Midi-Pyrénées, 31400 Toulouse, France^86

[144]GHD Canada, Waterloo, Ontario, Canada^54

[145]Geology and Applied Geology Unit, Faculty of Engineering, University of Mons, Place du Parc 20, 7000 Mons, Belgium^89

[146]Georgikon Faculty, University of Pannonia, Deák Ferenc u. 16, 8360 Keszthely, Hungary^48

[147]Global Health Unit, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands^392

[148]Grantham Institute – Climate Change and the Environment, Imperial College London, London, UK^64

[149]Grigore Antipa National Museum of Natural History, Sos. Kiseleff Nr. 1, 011341 Bucharest, Romania^39

[150]Groundwater and Quaternary Geology Mapping Department, Geological Survey of Denmark and Greenland, Aarhus, Denmark^82

[151]Guangzhou Key Laboratory Environmental Catalysis and Pollution Control, Guangdong Key Laboratory of Environmental Catalysis and Health Risk Control, School of Environmental Science and Engineering, Institute of Environmental Health and Pollution Control, Guangdong University of Technology, Guangzhou 510006, China^22

[152]HR Wallingford, Howbery Park, Wallingford, Oxfordshire OX10 8BA, UK^65

[153]Haaglanden Medical Centre^273

[154]Harvard, Cambridge, USA^149

[155]Health Care Biotechnology Department, Atta ur Rahman School of Applied Biosciences, National University of Sciences & Technology, Islamabad, Pakistan^362

[156]Health Outcomes Strategies GmbH, Basel, Switzerland^365

[157]Health Promotion and System Strengthening Project, Dodoma, Tanzania^382

[158]Health System Resource Center, President’s Office Regional Administration and Local Government, Dodoma, Tanzania^380

[159]Hospital Geral de Nova Iguaçu, Nova Iguaçu, Brasil^126

[160]Hospital Geral, Nova Iguaçu, Brasil^336

[161]Hospital Otávio de Freitas, Recife, Brasil^289

[162]Hospital Regional João Penido, Juiz de Fora, Brasil^294

[163]Howard University, Washington DC, United States of America^138

[164]Humber River Hospital^252

[165]Imperial College London, London, United Kingdom^150

[166]Infectious Disease Research Institute, Seattle, USA^203

[167]Institut Pasteur de la Guyane, Cayenne, French Guiana^199

[168]Institut Pasteur, Paris, France^147

[169]Institute for Soil Sciences and Agricultural Chemistry, Centre for Agricultural Research, Hungarian Academy of Sciences, Herman Ottó út 15, 1022 Budapest, Hungary^47

[170]Institute of Atmospheric and Cryospheric Sciences, University of Innsbruck, Innsbruck, Austria^103

[171]Institute of Hydrology and Water Resources Management, Leibniz Universität Hannover, Hannover, Germany^97

[172]Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences, Lahore, Pakistan^375

[173]Institute of Physics, University of São Paulo, São Paulo, Brazil^14

[174]Institute of Tropical Medicine, Belgium^310

[175]Institute of Urban Meteorology, China Meteorological Administration, Beijing 100089, China^2

[176]Instituto Adolfo Lutz, São Paulo, Brasil^122

[177]Instituto Evandro Chagas, Ananindeua, Brasil^143

[178]Instituto Federal de Ciência e Tecnologia do Sertão Pernambucano, Brasil^288

[179]Instituto Lauro de Souza Lima, Bauru, Brasil^334

[180]Instituto Mexicano del Seguro Social, Guadalupe, México^194

[181]Instituto Mexicano del Seguro Social, Monterrey, México^164

[182]Instituto Mexicano del Seguro Social, Zacatecas, Mexico^189

[183]Instituto Nacional de Ciencias Médicas y de la Nutrición Salvador Zubirán, Ciudad de México, México^191

[184]Instituto Nacional de Ciência e Tecnologia em Entomologia Molecular, Rio de Janeiro, Brasil^186

[185]Instituto Nacional de Câncer, Rio de Janeiro, Brasil^290

[186]Instituto Nacional de Medicina Tropical, Puerto Iguazú, Argentina^159

[187]Instituto Nacional de Salud, Bogotá, Colombia^155

[188]Instituto Oswaldo Cruz-Fiocruz, Rio de Janeiro, Brazil^325

[189]Instituto de Biologia Molecular do Paraná, Curitiba, Brasil^209

[190]Instituto de Prevenção de Câncer, Fortaleza, Brazil^324

[191]Instituto de Salud Carlos III, Madrid, Spain^157

[192]Integrated Water Systems and Governance, IHE Delft, Delft, the Netherlands^76

[193]Internal Medicine Department^221

[194]Internal Medicine^212

[195]Invited contribution by Arnaud Watlet, recipient of the EGU Hydrological Sciences Outstanding Student Poster and PICO Award 2016^91

[196]Isala Clinics^281

[197]John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA^7

[198]Kansas Geological Survey, University of Kansas, Lawrence, KS 66047, USA^102

[199]Karst Research Institute ZRC SAZU, Titov trg 2, 6230 Postojna, Slovenia^51

[200]Key Lab. of Environmental Optics and Technology, Anhui Institute of Optics and Fine Mechanics, Chinese Academy of Sciences, Hefei 230031, China^26

[201]Key Laboratory for Aerosol-Cloud-Precipitation of China Meteorological Administration, School of Atmospheric Physics, Nanjing University of Information Science & Technology, Nanjing 210044, China^5

[202]King Faisal University, College of Clinical Pharmacy, Al-Ahsa, Saudi Arabia^371

[203]Kintampo Health Research Centre, Ghana Health Service, Kintampo, Ghana^385

[204]Kintampo Health Research Centre, Kintampo, Ghana^388

[205]Korea Institute of Science and Technology, Seoul, 02792, Republic of Korea^100

[206]Kuwait Pharmaceutical Association, Kuwait City, Kuwait^364

[207]LEGOS-GRGS, UMR 5566, CNRS/IRD/UPS, Observatoire Midi-Pyrénées, 31400 Toulouse, France^87

[208]Laboratoire de Planétologie et Géodynamique – Nantes (LPGN), UFR Sciences et Techniques, Université de Nantes, UMR-CNRS 6112, Rue de la Houssinière 2, BP92208, 44322 Nantes CEDEX 3, France^92

[209]Laboratory for Cellular Proliferation and Differentiation^342

[210]Laboratory for Veterinary Clinical Pathology^346

[211]Laboratory of Arthropods^351

[212]Laboratory of Pharmacology^337

[213]Laboratory of Physiochemical Quality Control^349

[214]Laboratório Central de Saúde Pública, Brasília, Brasil^299

[215]Laboratório Central de Saúde Pública, Fortaleza, Brazil^320

[216]Leiden University Medical Centre^274

[217]LuftBlick, Innsbruck, Austria^104

[218]Maastricht University Medical Centre^271

[219]McMaster University^259

[220]Medicines Law & Policy, Amsterdam, The Netherlands^393

[221]Medicines Law & Policy, Contamine sur Arve, France^395

[222]Mediterranean Agronomic Institute (MAIB) – Land and Water Department, Valenzano (Bari), Italy^78

[223]Meteorological Service of Canada, Environment and Climate Change Canada, Dartmouth, Canada^71

[224]Meteoswiss, Payerne, Switzerland^72

[225]Ministerio de Salud, Santiago, Chile^118

[226]Ministry of Health, Iquitos, Peru^332

[227]Ministério da Agricultura, Pecuária e Abastecimento, Pedro Leopoldo, Brasil^293

[228]Ministério da Saúde, Brasília, Brasil^205

[229]Monash University, School of Pharmacy, Clayton, Australia^374

[230]NIOZ Royal Netherlands Institute for Sea Research, Department of Ocean Systems, 1790 AB Den Burg, the Netherlands^40

[231]Nacional Colonia La Campaña, Tegucigalpa, Honduras^111

[232]National Center For Atmospheric Research, Research Application Laboratory, Boulder, CO, USA^42

[233]National Center for Atmospheric Research, Boulder, USA^70

[234]National Centre for Groundwater Research and Training, School of the Environment, Flinders University, Adelaide, SA 5001, Australia^99

[235]National Chung Cheng University, Chia-Yi, Taiwan^313

[236]National Chung Hsing University, Taichung, Taiwan^316

[237]National Hydrology Research Centre, Saskatoon, Saskatchewan, Canada^59

[238]National Institute for Public Health and the Environment, the Netherlands^309

[239]National Institute of Marine Geology and Geoecology (GeoEcoMar), 23–25 Dimitrie Onciul St., 024053 Bucharest, Romania^36

[240]National Taiwan University Hospital, Taipei, Taiwan^314

[241]Naturalis Biodiversity Center, P.O. Box 9517, 2300 RA Leiden, the Netherlands^32

[242]Neonatal Unit^215

[243]Niagara Health^255

[244]Niagara Regional Campus, Michael G DeGroote School of Medicine^258

[245]Northeastern Ohio Medical University^231

[246]Northwest Clinics^277

[247]Norwegian Meteorological Institute, Oslo, Norway^69

[248]Palaeomagnetic Laboratory “Fort Hoofddijk”, Faculty of Geosciences, Utrecht University, Budapestlaan 17, 3584 CD Utrecht, the Netherlands^34

[249]Palliative and Supportive Services^249

[250]Pan American Health Organization, Washington DC, USA^112

[251]Pediatrics^214

[252]Pharmacists Manitoba, Winnipeg, Canada^397

[253]Pharmacy Board of Sierra Leone, Freetown, Sierra Leone^357

[254]Planning and Quality Improvement^245

[255]Professional Practice^251

[256]Queen's University, Centre for Health Services and Policy Research^282

[257]Queen’s University, School of Rehabilitation Therapy^284

[258]Queen’s University^263

[259]Radboud University Medical Center, Institute for Health Sciences, Radboud University, Nijmegen, Netherlands^386

[260]Radboud University Medical Centre^272

[261]Rede Proteômica do Rio de Janeiro, Rio de Janeiro, Brasil^174

[262]Regional Medical Officer, Regional Administrative Secretary’s Office, Dodoma, Tanzania^381

[263]Regional Pharmacist, Regional Administrative Secretary’s Office, Dodoma, Tanzania^383

[264]School of Counseling^244

[265]School of Environmental Science and Optoelectronic Technology, University of Science and Technology of China, Hefei 230027, China^28

[266]School of Health Sciences^234

[267]School of Mathematics and Physics, Anhui University of Technology, Ma'anshan 243032, China^31

[268]School of Nursing^243

[269]School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada^398

[270]School of Social Work^242

[271]Science Island Branch of Graduate School, University of Science and Technology of China, Hefei 230026, China^27

[272]Scientific Center for Quality of Healthcare, Radboud University Medical Center, Institute for Health Sciences, Radboud University, Nijmegen, Netherlands^391

[273]Secretaria de Estado da Saúde de São Paulo, São Paulo, Brasil^142

[274]Secretaria de Estado da Saúde do Espírito Santo, Vitória, Brasil^135

[275]Secretaria de Estado da Saúde do Piauí, Teresina, Brasil^210

[276]Secretaria de Estado de Saúde do Rio de Janeiro, Rio de Janeiro, Brasil^302

[277]Secretaria de Saúde do Estado do Ceará, Fortaleza, Brazil^326

[278]Section of Endocrinology, Internal Medicine Department^224

[279]Seismology-Gravimetry, Royal Observatory of Belgium, Avenue Circulaire 3, 1180 Uccle, Belgium^90

[280]Senior Administration^257

[281]Senior Health^240

[282]Senior pharmaceutical consultant, Dar es Salaam and senior lecturer at St. John’s University of Tanzania, Dodoma, Tanzania^378

[283]Senior pharmaceutical consultant, Dar es Salaam, Dodoma, Tanzania^379

[284]Seniors Institute Research^236

[285]Shu-Zen Junior College of Medicine and Management, Kaohsiung City, Taiwan^318

[286]South London and Maudsley NHS Foundation Trust^227

[287]Southern Illinois University Carbondale, Carbondale, USA^120

[288]Southern Illinois University, Carbondale, USA^119

[289]St Antonius Hospital^278

[290]State Environmental Protection Key Laboratory of Urban Ambient Air Particulate Matter Pollution Prevention and Control, College of Environmental Science and Engineering, Nankai University, Tianjin 300071, China^1

[291]State Key Laboratory of Water Resources and Hydropower Engineering Science, Wuhan University, Wuhan 430072, P.R. China^83

[292]Statistics Sierra Leone, Freetown, Sierra Leone^390

[293]Summa Health System^237

[294]Summa Health^233

[295]Superintendência de Controle de Endemias, São Paulo, Brasil^136

[296]Swiss Tropical and Public Health Institute, Basel, Switzerland^376

[297]Syreon Research Institute, Budapest, Hungary^369

[298]Taichung Veterans General Hospital, Taichung, Taiwan^319

[299]Texas Tech University Health Sciences Center, El Paso, USA^303

[300]The University of Akron^229

[301]The University of Arizona, Department of Pharmacy Practice, College of Pharmacy, Tucson, USA^372

[302]These authors contributed equally to this work^33

[303]Tropical Medicine Institute Pedro Kourí, Havana, Cuba^154

[304]UFZ-Helmholtz Centre for Environmental Research, Department of Computational Hydrosystems, Leipzig, Germany^43

[305]US Department of Energy Joint Genome Institute, Walnut Creek, USA^315

[306]Universidad Anahuac, Mexico Norte, Mexico^196

[307]Universidad Autónoma de Madrid, Madrid, Spain^166

[308]Universidad Autónoma de Nuevo León, Monterrey, México^165

[309]Universidad Autónoma de San Luis Potosí, San Luis Potosí, Mexico^190

[310]Universidad Metropolitana de Ciencias de la Educación, Santiago, Chile^117

[311]Universidad Nacional Autónoma de México, Ciudad de Mexico, Mexico^195

[312]Universidad Nacional de Asunción, Asunción, Paraguay^162

[313]Universidad Peruana Cayetano Heredia, Lima, Peru^331

[314]Universidad de Chile, Santiago, Chile^116

[315]Universidad de Pamplona, Cúcuta, Colombia^153

[316]Universidad de la República, Montevideo, Uruguay^161

[317]Universidad de la República, Paysandú, Uruguay^163

[318]Universidade Estadual Paulista Júlio de Mesquita Filho, Botucatu, Brazil^335

[319]Universidade Estadual Paulista, Araraquara, Brasil^176

[320]Universidade Estadual Paulista, Botucatu, Brasil^181

[321]Universidade Estadual Paulista, Jaboticabal, Brasil^178

[322]Universidade Estadual Paulista, Rio Claro, Brasil^179

[323]Universidade Estadual de Londrina, Londrina, Brasil^141

[324]Universidade Estadual de Ponta Grossa, Ponta Grossa, Brasil^301

[325]Universidade Estadual do Ceará, Fortaleza, Brazil^321

[326]Universidade Estadual do Norte Fluminense Darcy Ribeiro, Campos dos Goytacazes, Brazil^308

[327]Universidade Estadual do Sudoeste da Bahia, Jequié, Brasil^132

[328]Universidade Federal Fluminense, Niterói, Brasil^140

[329]Universidade Federal Rural do Rio de Janeiro, Seropédica, Brasil^295

[330]Universidade Federal de Goiás, Goiânia, Brasil^296

[331]Universidade Federal de Juiz de Fora, Governador Valadares, Brasil^202

[332]Universidade Federal de Juiz de Fora, Juiz de Fora, Brasil^188

[333]Universidade Federal de Minas Gerais, Belo Horizonte, Brasil^131

[334]Universidade Federal de Ouro Preto, Ouro Preto, Brazil^327

[335]Universidade Federal de Pelotas, Capão do Leão, Brasil^144

[336]Universidade Federal de Pelotas, Pelotas, Brasil^129

[337]Universidade Federal de Pernambuco, Recife, Brasil^287

[338]Universidade Federal de Rondônia, Porto Velho, Brasil^170

[339]Universidade Federal de Sergipe, Aracaju, Brasil^137

[340]Universidade Federal de São Carlos, São Carlos, Brasil^180

[341]Universidade Federal de São João Del-Rei, Divinópolis, Brasil^169

[342]Universidade Federal de Viçosa, Viçosa, Brasil^184

[343]Universidade Federal do Amazonas, Manaus, Brasil^171

[344]Universidade Federal do Ceará, Fortaleza, Brazil^323

[345]Universidade Federal do Espírito Santo, Vitória, Brasil^134

[346]Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brasil^125

[347]Universidade Federal do Paraná, Curitiba, Brasil^206

[348]Universidade Federal do Pará, Belém, Brasil^145

[349]Universidade Federal do Rio Grande do Norte, Natal, Brasil^201

[350]Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil^128

[351]Universidade Federal do Rio de Janeiro, Duque de Caxias, Brasil^175

[352]Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil^124

[353]Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil^307

[354]Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brasil^133

[355]Universidade de Brasília, Brasília, Brasil^107

[356]Universidade de Campinas, Campinas, Brasil^298

[357]Universidade de Pernambuco, Recife, Brasil^198

[358]Universidade de São Paulo, São Carlos, Brasil^177

[359]Universidade de São Paulo, São Paulo, Brasil^130

[360]Universidade de São Paulo, São Paulo, Brazil^333

[361]Universidade do Estado do Amazonas, Manaus, Brasil^114

[362]Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil^146

[363]University Hospital Essen^265

[364]University Hospital of Giessen and Marburg, Standort Giessen^280

[365]University Medical Centre Groningen^276

[366]University Medical Centre Utrecht^275

[367]University at Albany, State University of New York, Albany, USA^328

[368]University of Amsterdam^264

[369]University of Basel, Basel, Switzerland^377

[370]University of Basilicata, School of Agricultural, Forestry and Environmental Sciences – Hydraulics and Hydrology Division, Potenza, Italy^79

[371]University of Birmingham, Edgbaston, UK^158

[372]University of California San Diego, La Jolla, USA^330

[373]University of California, Los Angeles, USA^317

[374]University of Florida College of Medicine^218

[375]University of Florida College of Public Health and Health Professions^220

[376]University of Geneva, Geneva, Switzerland^187

[377]University of Ghana, Legon, Ghana^109

[378]University of Leeds, Leeds, UK^173

[379]University of Ostrava, Ostrava, Czech Republic^185

[380]University of Sydney, Sydney, Australia^152

[381]Université Paul Sabatier, Toulouse, France^193

[382]VU Medical Centre^270

[383]Wadsworth Center, Albany, USA^329

[384]Water Institute and Department of Earth and Environmental Sciences, University of Waterloo, Waterloo, Ontario, Canada^60

[385]Water Resources Section, Delft University of Technology, Delft, the Netherlands^77

[386]Wegener Center for Climate and Global Change, University of Graz, Graz, Austria^96

[387]Western Kentucky University, Bowling Green, USA^121

[388]World Meteorological Organization, Geneva, Switzerland^68

[389]Yale New Haven Health Bridgeport Hospital^222

[390]Yale School of Medicine^225

[391]now at: Agrarian Sciences Institute, Federal University of Uberlândia, Minas Gerais, Brazil^16

[392]now at: Coldwater Laboratory, University of Saskatchewan, Canmore, Alberta, Canada^45

[393]now at: College of Environmental Science and Engineering, Peking University, Beijing, China^17

[394]now at: Department of Atmospheric Sciences, University of Washington, Seattle, WA, USA^10

[395]now at: Department of Civil and Environmental Engineering, Virginia Tech, Blacksburg, VA, USA^13

[396]now at: IMT Lille Douai, Université Lille, SAGE, Lille, France^15

[397]previously published under the name Tóth^49

[398]‘Carol Davila’ University of Medicine and Pharmacy^266

关键词: Pharmacare;    Canada;    Prescription drugs;    Health insurance;    Health policy;    Healthcare economics;    Politics;   

DOI  :  10.1186/s40545-018-0154-x

学科分类：药理学

来源: BioMed Central

【 摘 要 】

Canadians have long been proud of their universal health insurance system, which publicly funds the cost of physician visits and hospitalizations at the point of care. Prescription drugs however, have been subject to a patchwork of public and private coverage which is frequently inefficient and creates access barriers to necessary medicine for many Canadians. A narrative review was undertaken to understand the important economic, policy and political considerations regarding implementation of universal prescription drug access in Canada (pan-Canadian pharmacare). PubMed, SCOPUS and google scholar were searched for relevant citations. Citation trails were followed for additional information sources. Published books, public reports, press releases, policy papers, government webpages and other forms of gray literature were collected from iterative internet searches to provide a complete view of the current state on this topic. Regarding health economics, all five of the reviewed pharmacare simulation models have shown reductions in annual prescription drug expenditure. However, differing policy and cost assumptions have resulted in a wide range of cost-saving estimates between models. In terms of policy, a single-payer, ‘first-dollar’ coverage model, using a minimum national formulary, is the model most frequently advocated by the academic community, healthcare professions and many public and patient groups. In contrast, a multi-payer, catastrophic ‘last-dollar’ coverage model, more similar to the current “patchwork” state of public and private coverage, is preferred by industry drug manufacturers and private health insurance companies. Primary concerns from the detractors of universal, single-payer, ‘first-dollar’ coverage are the financing required for its implementation and the access barriers that may be created for certain patient populations that are not majorly present in the current public-private payer mix. Canada patiently awaits to see how the issue of prescription drug coverage will be resolved through the work of the Advisory Council on the Implementation of National Pharmacare. The overarching and ongoing discourse on policy and program implementation may be construed as a political debate informed by divergent public and private interests.

【 授权许可】

Unknown