sa¹ú¼Ê´«Ã½

As the cost of prescription drugs climbs ever higher, essential medications are becoming unaffordable for many sa¹ú¼Ê´«Ã½ families. In 1985, adjusting for inflation, British Columbians spent an average of $196 on drugs. Today, the total is close to $500.

And those figures understate the problem, because they spread costs across the population. Older people, who tend to have multiple prescriptions, are much harder hit. Many senior citizens face bills of $1,000 or more a year, even after the Fair Pharmacare program kicks in.

Efforts to flatten the cost curve have been made. The Health Ministry recently negotiated lower prices for generics, copies of brand-name products with cheaper price tags. That has slowed the upward trend, but only for a time.

Whole new classes of medication are moving through the design process, which will further strain the family budget. Many of these are drugs customized to the individual patient. Future cancer treatments, in particular, are expected to build on this model.

But the more specialized a drug is, the more it costs. And these new therapies will have 20 years of patent protection, meaning generic alternatives won’t be available soon.

It is essential, therefore, that additional economies are found. Here are some options worth considering.

First, the ministry should halt the price-gouging that far too many pharmacies engage in. The maximum dispensing fee is supposed to be $10 per prescription. This is the limit government will pay when a customer is covered by Fair Pharmacare. But some drug stores charge as high as $13.50.

Patients who get assistance under the Pharmacare program pay the add-on. Everyone else pays the whole amount.

Strictly speaking, this is legal. The government allows drugstores to exceed the $10 limit, so long as the customer picks up the tab.

But there’s no excuse for a 35 per cent markup. The ministry should advise pharmacy owners that it will do business only with those who respect the $10 maximum.

Until that happens, readers might want to visit a website run by Pacific Blue Cross. Pharmacycompass.ca lets viewers compare the cost of prescriptions at any drugstore in sa¹ú¼Ê´«Ã½

Second, it should be possible to transfer some drugs from the prescription category to over-the-counter. A number of experts believe statins (used to combat high cholesterol) and birth-control pills could be safely transferred. This would save consumers millions in dispensing fees.

Third, the ministry should consider loosening the policy that no drug prescription may exceed 100 days’ supply.

In general, there are good reasons for this rule. Some medications, such as habit-forming barbiturates, antibiotics or drugs with a black-market value, should be dispensed only in small quantities.

Yet there are numerous illnesses, such as asthma or high blood pressure, where treatment might extend over decades. Of the 10 most commonly used drugs in sa¹ú¼Ê´«Ã½, seven are for chronic conditions and none of them are habit-forming or resold on the street.

The 100-day rule is a significant cost-driver for patients with these ailments. If physicians were allowed to write year-long prescriptions in such cases, a rough estimate is that patients might save about $20 million annually in dispensing fees. The ministry would also benefit, through savings to the Pharmacare program.

In practice, GPs already acknowledge the merit of this approach by writing prescriptions with refills added on. So the patient gets a year’s supply, but still has to pay a dispensing fee every 100 days.

No doubt some stiff challenges lie ahead. But the key actors — government, drug manufacturers and pharmacists — owe us some form of relief. Wonder drugs will lose their promise if they cannot be made affordable.