Out of pocket payment for drugs vary among provinces.

Drug plans are not a universal aspect of Canada's health care system, a research report points out.

The drugs covered by the provincial government varies widely from province to province and therefore the out of pocket amounts expended by individuals range widely. A study, headed by Dr. Louise Pilote of McGill University and reported in the Canadian Medical Association Journal (Feb. 14/08), describes the variation. "A revised pharmaceutical strategy might reduce these major inequities," the researchers state.

Reimbursement for outpatient prescription drugs is not mandated by the Canada Health Act or any other federal legislation. Provincial governments independently establish reimbursement plans, usually for seniors, low-income earners and for special cases of catastrophic drug costs.

The researchers found that:

* the eligibility criteria and cost-sharing details of the publicly funded prescription drug plans differed markedly across Canada, as did the personal financial burden due to prescription drug costs;

* seniors pay 35% or less of their prescription costs in 2 provinces, but elsewhere they may pay as much as 100%;

* with few exceptions, non-seniors pay more than 35% of their prescription costs in every province;

* most social assistance recipients pay 35% or less of their prescription costs in 5 provinces and pay no costs in the other 5.

A patient with congestive heart failure, facing out of pocket costs for a prescription burden of $1,283, would have to pay between $74 and $1,332 across the provinces.

While there are wide differences in the eligibility and coverage across the country, prescription drug coverage is universally available to one group: social assistance recipients.

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