Canadian Medical Association

With pharmacare back on the national agenda, we surveyed e-Panel members to learn more about their experiences prescribing medication to patients and to gather perspectives on what a Canadian pharmacare program should look like.

July 2018

Distributed to:
3,276 e-Panel members


Response rate:

Want to share your perspective? Visit the CMA Member Voice e-Panel page for more information on how to participate in future surveys.

I am tired of the mix of systems and the consequent ‘holes in the Swiss cheese’ that seem to result in patients failing through the cracks of the system. If we are going to bother with a pharmacare system, then ‘go big or go home’ — make it national, reasonable and simple.

- CMA Member Voice e-Panel respondent

What members said

Awareness of costs of prescription medications

85% of respondents said they are very or somewhat aware of the costs of the medications they prescribe to patients.

However, of these respondents, 71% most often learn about the costs of prescriptions first-hand from their patients. Other sources of cost information include:

  • Provincial drug formulary (38%)
  • Databases (e.g., RxTx) (34%)
  • Pharmaceutical representatives (28%)
  • Pharmacists (12%)
  • Journals (4%)
  • Electronic medical record (4%)

Patient drug coverage

71% of respondents frequently ask patients about their drug coverage, and results indicate that coverage is a prevalent and challenging barrier for many patients.

We asked participants to estimate how many of their patients have no or inadequate drug coverage, and whether this estimation influences their prescription decision. 60% said that more than 20% of the patients they see have inadequate coverage. More than 90% said a patient’s lack of drug coverage influences their decision on what to prescribe or how to proceed with treatment.

When a patient can’t afford the prescribed medications, respondents said they often or always:

  • Prescribe a different medication (67%)
  • Offer alternative therapies (57%)
  • Provide samples (33%)
  • Advise prioritizing medications if they cannot afford some (20%)
  • Assist by getting coverage from the pharmaceutical company (19%)

Regarding the actions patients take when they can’t afford a prescribed medication, respondents said patients often or always:

  • Do not fill the prescription (46%)
  • Take less medications than prescribed (43%)
  • Fill the prescription and take it as prescribed (34%)
  • Take medications prescribed for someone else (15%)

Formulary coverage issues

We asked physicians how frequently they run into formulary coverage issues with patients under private coverage compared to those under public coverage. 54% said they often or always encounter such issues with patients under public coverage, while only 13% reported the same of private coverage.

In addition, 47% of respondents said they often or always request special authorization for drugs with patients covered under public coverage. Only 12% said the same for patients under private coverage.

Features of a national pharmacare program

Respondents identified the elements they see as very important to a national, publicly funded pharmacare program:

  • A simple process for obtaining special authorization (74%)
  • Ensure coverage for all Canadians/permanent residents (73%)
  • Lower overall drug costs for Canada (71%)
  • Have a broad formulary (57%)
  • Small or no co-payments (46%)

We also asked about their preferred option for a national prescription drug program:

  • Single national pharmacare (57%)
  • Mix of private prescription drug plans and public drug plans (34%)
  • Separate regional pharmacare plans (9%)

Although I think a single federal program would likely be best to ensure all have equal access, I don’t think it is financially feasible. A mix of private coverage with a federal ‘safety net’ could ensure people are getting the medications they need but those who can afford them are not costing more to the system.

- CMA Member Voice e-Panel respondent

Who responded

Chart showing respondent profile by language

Chart showing respondent profile by practise segment

Chart showing respondent profile by profile/territory

What’s next

These insights from our members helped us fine-tune our positions and policies related to pharmacare so we can continue to drive dialogue and bring the physician perspective to this important topic.

Other e-Panel survey summaries

See what CMA members had to say about other health topics:

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