TORONTO - A new report says per-capita spending on prescription drugs in Canada has taken a drop for the first time since the Second World War.
Canadians spent almost $23 billion on prescription drugs through retail pharmacies in 2012-13, or $650 per person — down one per cent from five years earlier.
But health economists who compiled the latest edition of the Canadian Rx Atlas predict that level will be short-lived due to shifts in drug costs.
Annual spending on drugs for hypertension, high cholesterol, heartburn and depression fell by $2 billion to $6.7 billion this year, mainly due to brand-name drug patents expiring.
However, spending on so-called specialist medications for such conditions as rheumatoid arthritis, HIV and cancer doubled to $3 billion in 2012-13.
The atlas shows that while the average cost for high blood pressure pills is $27, a prescription for anti-inflammatory drugs tops $2,100.
"The good news is we're spending far less than historic trends would predict, but tectonic changes are mounting beneath the calm surface," said Steve Morgan of UBC's school of population and public health and the atlas's lead author.
Morgan said more than a third of drugs now being developed by pharmaceutical companies are specialized, or "niche," drugs that will come to market with significant price tags.
"The pharmaceutical industry is moving towards a new revenue model — we see tell-tale signs of things to come from this Rx atlas," Morgan said. "Policy makers must act now to ensure fair pricing and equitable access before spending gets out of hand again."
The atlas revealed major differences in prescription drug spending between males and females over the last five years. Per capita spending for antidepressants taken by women was double that of men. In the 40-64 age group, for instance, women spent $550 million per year on antidepressants compared to $270 million spent by men.
Annual spending on antidepressants rose to $1.4 billion in 2012-13 from $1.3 billion in 2007-08, but such factors as population growth and an aging demographic don't account for the rising costs, the authors said.
"Studies in the U.S. have shown that many people prescribed antidepressants do not have a psychiatric diagnosis, and that this is why antidepressant use is so common," commented Barbara Mintzes, an assistant professor in UBC's department of pharmacology and therapeutics.
"The volume of use we're seeing across Canada suggests that the same thing may also be happening here."
Among children and adolescents up to age 18, the atlas found unusually high spending on ADHD and asthma drugs for boys, suggesting that research is needed to determine if social factors and over-prescribing might be at play.