The Impact of Out-of-Pocket Costs within the BC PharmaCare Program

Project number: 
15-043
Approval date: 
Monday, June 1, 2015
Principal Investigator: 
Law,Mike
Institution: 
Centre for Health Services and Policy Research (CHSPR)
Funding Agency: 
Institute for Health System Transformation and Sustainability,Canadian Institutes of Health Research
Datasets requested: 
Medical Services Plan (BC Ministry of Health)
Consolidation - demographic (Ministry of Health)
Hospital Separations (BC Ministry of Health)
Consolidation registry (Ministry of Health)
Deaths (BC Vital Statistics Agency)
MSP Registration & Premium Billing(BC Ministry of Health)
PharmaNet
Research objective: 

Fair PharmaCare Income Thresholds:

Question: What is the impact of a higher deductible at the Fair PharmaCare income thresholds on prescription drug use, costs, adherence, and health outcomes?
Hypothesis: Higher deductibles reduce the use of prescription drug treatment, adherence, and increase adverse health outcomes.

Fair PharmaCare Age Threshold:

Question: What is the impact of a higher deductible for those born after 1939 on prescription drug use, costs, adherence, and health outcomes?
Hypothesis: Higher deductibles reduce the use of prescription drug treatment, adherence, and increase adverse health outcomes.

No Charge Psychiatric Medication Plan Expiry:

Question: What is the impact of the expiry of the no charge psychiatric medication plan on prescription drug use, costs, adherence, and health outcomes?
Hypothesis: The expiry of the no charge psychiatric plan reduces the use of prescription drug treatment, reduces adherence, and increases adverse health outcomes.

Other Household Member Starts Long-term High Cost Therapy:

Question: What is the impact of a household member starting on a long-term high cost therapy on another household member's prescription drug use, costs, adherence, and health outcomes?
Hypothesis: Another household member starting on a long-term high cost therapy increases prescription drug use, improves adherence, and decreases adverse health outcomes in other members of the household.

Fair PharmaCare Deductible Rollover:

Question: What is the impact of an individual fulfilling their household deductible at some point during a calendar year on particular clinical events?
Hypothesis: Fulfilling a household deductible will increase prescription drug use, improve adherence, and decrease adverse clinical events.

Chronic Conditions:

Question: Do any of the above relationships vary for individuals with specific chronic conditions (diabetes, COPD, heart failure, post-myocardial infarction)?
Hypothesis: Deductibles have had an observable detrimental effect on health outcomes for individuals with chronic conditions.

Publications: 

Journal Publication

  • Law MR, Cheng L, Worthington HC, Majumdar SR, McGrail KM, Chan F, Laba T, Mamdani M (2019). The Impact of a Household-level Deductible on Drug Use among Lower Income Adults. CMAJ Open 7: E167-E173
  • Law MR, Cheng L, Worthington H, Mamdani M, McGrail KM, Chan FKI, Majumdar SR (2017). Impact of income-based deductibles on drug use and health care among older adults. CMAJ 189 (19) E690-E696

Academic thesis or dissertation

  • Chan FKI (2017). An examination of influences on prescription drug use amongst older adults with and without chronic illness in two Canadian provinces. MSc thesis.

Page last revised: September 2, 2019