ArticleCMAJ open2018
The consequences of patient charges for prescription drugs in Canada: a cross-sectional survey.
Article in CMAJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
46 citing papers in PubMed, 1 synthesis or guideline pooled it, 92 citations in OpenAlex.
- Cost-related medication nonadherence in Canada: a systematic review of prevalence, predictors, and clinical impact.Systematic reviews · 2021Pooled it
- Adherence at 2 years with distribution of essential medicines at no charge: The CLEAN Meds randomized clinical trial.PLoS medicine · 2021Trial
- Disparities in cost-related prescription nonadherence between Black and White adults in Canada.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2026Article
- From patient voices to policy: Data analytics reveals patterns in Ontario's hospital feedback.PLOS digital health · 2026Article
- Providers' Perspectives and Experiences with Cost-Related Nonadherence to Medications: A Thematic Analysis.Risk management and healthcare policy · 2026Article
- Ethnic differences in weight loss during a clinical obesity management program.Clinical obesity · 2025Article
- Universal Pharmacare and Contraceptive Dispensations Among Youth.JAMA pediatrics · 2025Article
- Effect of universal no-cost coverage on use of long-acting reversible contraception and all prescription contraception: population based, controlled, interrupted time series analysis.BMJ (Clinical research ed.) · 2025Article
- Predictors of cost-related medication nonadherence in Canada: a repeated cross-sectional analysis of the Canadian Community Health Survey.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2024Article
- Access to Treatment for Chronic Obstructive Pulmonary Disease in the Americas: A Call for Action. A Joint Perspective from the Brazilian Thoracic Society, Canadian Thoracic Society, Latin American Thoracic Society, and the American Thoracic Society.Annals of the American Thoracic Society · 2024Article
- Patient perspectives on the vital primary care role of community pharmacists in Nova Scotia, Canada: qualitative findings from the PUPPY Study.The International journal of pharmacy practice · 2024Article
- The Intersectional Impact of Cost-Related Non-Adherence and Depression: A Cross-Sectional Analysis of the Canadian Community Health Survey by Sex, Race, and Indigeneity.Community mental health journal · 2024Article
- The Canadian dental care plan and the senior population.Frontiers in oral health · 2024Article
- Costs of major depression covered / not covered in British Columbia, Canada.BMC health services research · 2023Article
- Cost-of-living challenges highlight urgency for clinicians to prescribe affordable medications.Canadian family physician Medecin de famille canadien · 2023Article
- Exploring Biologic Treatment Hesitancy Among Black and Indigenous Populations in Canada: a Review.Journal of racial and ethnic health disparities · 2023Review
- Public-private partnership alternative for a national pharmacare program in Canada.Journal of pharmaceutical policy and practice · 2023Article
- The impact of prescription drug insurance on cost related non-adherence to medications in Canada: A Heckman sample selection approach.PloS one · 2023Article
- Collecting Information on Caregivers' Financial Well-Being: A Document Review of Federal Surveys in Canada.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2022Review
- Acceptability of a short list of essential medicines to patients and prescribers: Multimethod study.Canadian family physician Medecin de famille canadien · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMany Canadians face substantial out-of-pocket charges for prescription drugs. Prior work suggests that this causes some patients to not take their medications as prescribed; however, we have little understanding of whether charges for prescription medicines lead patients to forego basic needs or to use more health care services. Our study aimed to quantify the consequences of patient charges for medicines in Canada.
methodsAs part of the 2016 Canadian Community Health Survey, we designed and fielded cross-sectional questions to 28 091 Canadians regarding prescription drug affordability, consequent use of health care services and trade-offs with other expenditures. We calculated weighted population estimates and proportions, and used logistic regression to determine which patient characteristics were associated with these behaviours.
resultsOverall, 5.5% (95% confidence interval 5.1%-6.0%) of Canadians reported being unable to afford 1 or more drugs in the prior year, representing 8.2% of those with at least 1 prescription. Drugs for mental health conditions were the most commonly reported drug class for cost-related nonadherence. About 303 000 Canadians had additional doctor visits, about 93 000 sought care in the emergency department, and about 26 000 were admitted to hospital at the population level. Many Canadians forewent basic needs such as food (about 730 000 people), heat (about 238 000) and other health care expenses (about 239 000) because of drug costs. These outcomes were more common among females, younger adults, Aboriginal peoples, those with poorer health status, those lacking drug insurance and those with lower income.
interpretationOut-of-pocket charges for medicines for Canadians are associated with foregoing prescription drugs and other necessities as well as use of additional health care services. Changes to protect vulnerable populations from drug costs might reduce these negative outcomes.
Identifiers
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.