September 10, 2013

Lessons on Pharmacare from Around the World

written by Josie Newman

What's Available in France

In France, residents' prescriptions are covered by statutory public health insurance. But the degree to which a drug is publicly subsidized varies, depending on the necessity and efficacy of it. For that non-subsidized portion of prescriptions, many people rely on private insurance provided through their employer.   

There are four levels of reimbursement based on the degree to which a drug is considered safe, effective and essential, how well it treats serious health issues, and how high its therapeutic value is -- 100%, 65%, 30% and 15%. The average publicly funded reimbursement rate in France in 2007 was 76.77%.       

Only pharmacies are allowed to sell non-prescription drugs, whether they are kept behind the counter or out on the shelves. Costs for these are not reimbursed by the government.


Astronomical health care spending in France has caused the government in recent years to favor subsidizing generic drugs, which are usually 30% cheaper, over brand names. By 2011, 71% of publicly funded drugs were generic. In fact, people on social security are only allowed to use generic drugs. By 2010, health care spending was so out of control there was a 11.6 billion euro shortfall in France's health-care system but that is predicted to decrease to a 5.1 billion euro shortfall in 2013, largely due to the move towards generic drugs.   

September 4, 2013

More on Pharmacare: How Canada Ranks against other OECD Countries

written by Josie Newman

As Canadians, we pay one of the highest pharmaceutical rates per capita in the world, $691 annually. Many other OECD countries have effective, and heavily -- if not completely -- subsidized pharmacare systems, particularly New Zealand, the UK, and France.

New Zealand

In contrast to Canada, Annualper capita spending in New Zealand in 2007 was only $241, the lowest tracked rate globally. New Zealand also had the lowest prices of any country for the 30 most commonly prescribed drugs, and has one of the most effective pharmacare systems in the world.      

One of the reasons for that effective system is Pharmac, the crown corporation which legislates which drugs are subsidized and by how much, based on their effectiveness for a majority of patients. Pharmac shares the price and risk of similar medications with drug suppliers marketing a new drug as a way of negotiating costs and contracts with those suppliers. By doing so, Pharmac saved New Zealanders $80 million during a four year period!