British Columbia has the highest rate of residents in Canada who can’t afford to take their drug prescriptions as directed, according to a study published in the Canadian Medical Association Journal today.

An analysis by University of B.C. and University of Toronto researchers shows one in 10 Canadians cannot afford to take their prescription drugs as directed.

The highest rate of cost-related non-adherence was in B.C., at 17 per cent, compared with a low of 7.2 per cent in Quebec, the study reports.

“If you look at the study, what it shows and argues for is a national [drug] plan, and the Stephen Harper government seems uninterested in that, as does [B.C. Premier] Christy Clark,” B.C. NDP leader Adrian Dix said in an interview.

Based on data from 5,732 people who answered Statistics Canada’s 2007 Canada Community Health Survey, people living in B.C. were more than twice as likely to report not being able to afford their prescription drugs as those living in other large provinces, the report shows.

“This is cause for concern,” said Michael Law, assistant professor at UBC’s school of population and public health, in a news release.

The study reports that the characteristics most associated with not filling a prescription because of cost are: Not having insurance coverage for prescription drugs, being in poor health, having a low household income, being younger than 65 and living in British Columbia.

“The Canadian most likely to have problems affording their prescription drugs is in poor health, carries no drug insurance and lives in British Columbia,” Law said.

The study shows the predicted probabilities of not taking prescription drugs as directed due to cost range from 3.6 per cent among people with insurance and high household incomes to 35.6 per cent among people with low household incomes and no insurance.

“Our results clearly demonstrate that cost-related problems in accessing prescription drugs are disproportionately borne by the poor, the sick and the uninsured,” Law said.

The study reflects the higher absolute levels of inequality in B.C. and demonstrates the need for reforms, Dix said. He cited a need to pursue reference-based pricing and to lower B.C.’s price on generic drugs. People in other provinces, including Quebec and Ontario, pay 40 per cent less for generic drugs than in B.C., which “makes absolutely no sense,” said Dix.

“Shouldn't B.C. get the same deal as Quebec and Ontario?” Dix said Monday. “Should our province be making patients pay, and sick people pay, more for prescription drugs in British Columbia?”

Multinational companies are making “outrageous profits” while the middle-class and low-income people are struggling with costs dumped onto them, said Dix, whose party has cited the HST, higher MSP premiums, Hydro rates and growing housing costs as examples.

New Democrats want to see measures that include expanding reference-based pricing and academic detailing, supporting the Therapeutics Initiative, and negotiating a better price on generic drugs that at least matches Ontario and Quebec’s agreements with drug manufacturers.

It requires provincial leadership to demand federal action, said NDP health critic Mike Farnworth.

The results of the CMAJ study are timely, with the premiers’ Council of the Federation meeting taking place in Victoria Monday and Tuesday, Law said.

“As the provincial premiers meet in Victoria this week, they should consider expanding and improving public coverage for prescription drugs to reduce the influence of cost on whether or not Canadians can afford their prescription drugs,” Law said in a statement.

Prescription drugs fall outside of the Canada Health Act. Critics say that creates a patchwork of drug coverage that leaves two-thirds of Canadian households paying all or a portion of their prescription drug costs.

According to the study, about 10 per cent of Canadians who received a prescription chose not to either fill it or renew it, or skipped doses for cost reasons.

That’s particularly true for those without drug insurance — with 26.5 per cent reporting they can’t afford their prescription drugs.

“More than one in four Canadians without health insurance are forced, financially, to go without the prescription drugs they need,” Law said.

The authors of the report conclude: “Reducing cost-related non-adherence would likely improve health and reduce spending in other areas, such as admissions to hospital for acute care.

“Of all the factors we found to be associated with cost-related non-adherence, insurance coverage is the most amenable to being addressed through changes in public policy,” the report says.

The study is the first to examine the relationship between drug insurance and the use of prescription drugs in Canada.

The results are consistent with those from previous studies in the U.S., the report says.

ceharnett@timescolonist.com