BACKGROUNDER
2003HSER0013-000192 Feb. 24, 2003		Ministry of Health Services
IMPROVEMENTS UNDER FAIR PHARMACARE

PharmaCare is being modernized to provide fair access to prescription drug users. The new Fair PharmaCare program focuses financial assistance on B.C. families who need it most, based on their net income.

 

What PharmaCare Costs in B.C.

 

• PharmaCare subsidizes eligible prescription drugs and designated medical supplies, protecting British Columbians from high drug costs. 

 

• B.C.’s PharmaCare program has been the most generous in Canada, covering 53 per cent of drug costs compared with the national average of 43 per cent. B.C.’s new Fair PharmaCare program will cover 47 per cent of drug costs – higher than the national average and the second most generous program in Canada.   

 

• Today, PharmaCare costs over $700 million per year in B.C. and is the fastest growing portion of B.C.’s health-care budget.

 

• PharmaCare costs have increased by 147 per cent in the last decade, and costs are projected to increase by 487 per cent over the next two decades. Without changes, B.C.’s PharmaCare costs are estimated to increase to $8.7 million per day by 2021.

 

• Increasing costs and pressures on PharmaCare are due in part to an aging population, more listed drugs, new and expensive drugs, and greater use of drug therapies for treating illnesses.

 

• In the last decade, the number of prescriptions has increased by 51 per cent – and cost per prescription has increased by 63 per cent. For example, Remicade – a newly listed drug to treat severe rheumatoid arthritis under PharmaCare – is expected to cost $19,000 per patient for the first year of treatment.

 

Fair PharmaCare Financial Assistance

 

• Until now, PharmaCare has offered the same level of financial assistance to most British Columbians, without considering their ability to pay.

 

• The new Fair PharmaCare program helps B.C. residents pay for their prescription drugs, based on their family’s net income.

 

• For the first time, young families with lower incomes will be supported with their drug costs with the new approach. 
• Under Fair PharmaCare, over 1.3 million B.C. families and seniors – or 84 per cent of all families in B.C. – will pay the same or less for their prescription drugs. British Columbians with the lowest incomes will receive immediate financial assistance, with no deductible.

 

• Under the old approach, many British Columbians with lower incomes pay a higher portion of their prescription drug costs than those with higher incomes. For example, Barbara, a single mother earning $28,000 with no extended medical insurance, pays much more than a retired couple with a pension income of $56,000. The single mother pays $1,300, whereas the retired couple pays $550 for drugs and medical supplies costing $2,000 per year.

 

• Under Fair PharmaCare, Barbara will now pay $825 or 37 per cent less.

 

	OLD		NEW
Total Annual Drug Costs	Pharmacare Pays	Barbara Pays	Fair PharmaCare Pays	Barbara Pays
$2,000	$700	$1,300	$1,175 – 68% more	$825 – 37% less

 

• Another example: Bob and Mary are retired and earn $18,000 per year through their combined pensions. Their prescription drug costs total $2,000 per year. Under the old program, they pay $400 per year.  Under Fair PharmaCare, Bob and Mary will pay $250, or 38 per cent less.

 

	OLD		NEW
Total Annual Drug Costs	Pharmacare Pays	Bob and Mary Pay	Fair PharmaCare Pays	Bob and Mary Pay
$2,000	$1,600	$400	$1,750 – 9% more	$250 – 38% less

 

B.C.’s Fair PharmaCare Program

 

• Fair PharmaCare starts May 1. It combines the universal plan and the seniors’ plan into one new program.

 

• As in the past, B.C. families will pay their full prescription drug costs until they reach a level known as their deductible.

 

• PharmaCare will help B.C. families pay for eligible drug costs for the rest of the year, once their deductible is reached. For seniors, and those born in 1939 or earlier once they turn 65, PharmaCare will pay 75 per cent of eligible prescription drug costs, after their deductible is reached. For B.C. families who are not seniors, PharmaCare will pay 70 per cent of their eligible drug costs.

 

• To ensure British Columbians’ annual drug costs do not exceed their ability to pay, there will be a family maximum. Once the family maximum is reached, PharmaCare will cover 100 per cent of eligible drug costs for the year.

 

• The following tables show the deductibles and levels of financial assistance for B.C. seniors and families, based on their yearly net income.

 

• Those 65 or older receive the following Fair PharmaCare financial assistance:

 

Seniors’ Fair PharmaCare Program
Net Annual Family Income	Family Deductible	Portion PharmaCare Pays (once deductible reached)	Family Maximum (after which 100% of costs are covered)
Less than $33,000	None – Government assists you with your drug costs immediately	75% of prescription drug costs	Equal to 1.25% of your net income
Between $33,000 and $50,000	Equal to 1% of your net income	75% of prescription drug costs	Equal to 2% of your net income
Over $50,000	Equal to 2% of your net income	75% of prescription drug costs	Equal to 3% of your net income

 

• B.C. families other than seniors receive the following Fair PharmaCare financial assistance:

 

Fair PharmaCare Program
Net Annual Family Income	Family Deductible	Portion PharmaCare  Pays (once deductible reached)	Family Maximum (after which 100% of costs are covered)
Less than $15,000	None – Government assists you with your drug costs immediately	70% of prescription drug costs	Equal to 2% of your net income
Between $15,000 and $30,000	Equal to 2% of your net income	70% of prescription drug costs	Equal to 3% of your net income
Over $30,000	Equal to 3% of your net income	70% of prescription drug costs	Equal to 4% of your net income

 

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Media contact:	Public Affairs Bureau 250 952-1887