Table 2 – Pan-Canadian Pharmacare Models and Associated Fiscal Projections
Data Sources | Type of Coverage | Model Assumptions | Financing Source | Net Difference in Total System Expenditures | |
|---|---|---|---|---|---|
Morgan et al. (2015) [40] | -Canada Rx Atlas 2012/2013 for drug utilisation data [94] -International drug pricing data from PMPRB | -Public Universal ‘First Dollar’ | -Competitive pricing estimates as per singe-payer bulk-purchasing arrangement | -Federal/Provincial/Territorial (F/P/T) Government funding (tax based) -Small patient co-payments based on tiered national formulary | -Annual expense reduction of $4.2 to $9.4 billion |
Gagnon and Canadian Federation of Nurses Unions (2014) [43]a | -Canada Rx Atlas for drug utilisation data -International drug pricing data from PMPRB | -Public Universal ‘First-Dollar’ | -Competitive generic pricing estimates as per singe-payer bulk-purchasing arrangement −10% increase in base-expenditures due to higher utilisation -Improved evidence-based formulary management −2% reduction in dispensing fees -PMPRB pricing reform | -F/P/T Government (tax-based) -Small patient co-payments based on tiered national formulary | -Annual expense reduction of $2.7 to $11.5 billion |
PDCI Market Access inc. (2016) [41]a | -Canadian Drug Claims Database -International pricing data from PMPRB | -Varies ranging from fully public to fully private | -Numerous assumptions dependent upon model | -F/P/T Government funding (tax-based) -Private plan premiums -Patient co-payments | -$1.92 billion in annual expense reductions or up to $350 million in increased annual expenses |
Canadian Centre for Policy Alternatives & Canadian Doctors for Medicare (2017) [38]a | Canadian Institute for Health Information (CIHI) and previous studies | -Public Universal ‘First-Dollar’ | -Unclear -Data derived from various sources for approximate calculation | -F/P/T Government funding (tax-based) | -approximately $30 billion in total savings (unspecified time period) |
Parliamentary Budget Officer (2017) [18] | -CIHI datasets -Quintile IMS datasets | -Public Universal ‘First-Dollar’ | -Competitive generic pricing estimates as per singe-payer bulk-purchasing arrangement -Quebec drug formulary | -F/P/T Government funding (tax-based) -$5 co-payments (on patented products) | -annual expense reduction: $4.2 billion |