Managing Medication Cost Burden: A Qualitative Study Exploring Experiences of People with Disabilities in Canada

International Journal of Environmental Research and Public Health, 2019 · DOI: 10.3390/ijerph16173066 · Published: August 23, 2019

Healthcare Disability

Simple Explanation

This research explores how the rising costs of prescription drugs affect people with disabilities in Canada. It investigates the strategies they use, the factors that influence their choices, and the consequences of those strategies. The study involved interviewing 12 adults with spinal cord injuries to understand their experiences. Participants often sought help from the government, employers, or doctors before resorting to cutting back on medications. When help wasn't enough, people with disabilities used strategies like cutting back on medications, sacrificing essential needs, or selling assets. These choices had negative effects on their health, healthcare use, and quality of life.

Study Duration

6 Months

Participants

12 adults with spinal cord injuries

Evidence Level

Qualitative Study

Key Findings

1
Participants initially tried to improve drug coverage through government, employers, or prescribers before rationing medications.
2
Key factors influencing decisions included medication cost, perceived importance, financial status, competing needs, and prescriber relationships.
3
Rationing strategies, like cutting back on medications or essential needs, had serious implications for health, healthcare utilization, and quality of life.

Research Summary

This qualitative study explored the experiences of persons with disabilities managing their prescription drug costs in Canada. Participants were interviewed to determine the strategies they adopted, the factors influencing their decisions, and the impact of rationing strategies on individuals. The study found that participants initially sought help from government, employers, or doctors before resorting to rationing strategies. Key factors influencing decisions included medication cost, financial status, competing needs, and relationships with prescribers. Rationing strategies, such as cutting back on medications or essential needs, had serious implications for participants' health, healthcare utilization, psychological well-being and overall quality of life, highlighting the costs and inefficiency impact to the healthcare system.

Practical Implications

Policy Changes

Governments should simplify drug insurance processes, provide generous coverage for diverse disabilities, reconsider heavy deductibles, and minimize approval wait times.

Healthcare Provider Awareness

Prescribing healthcare professionals should be aware of patients at risk of out-of-reach medication costs and consider coverage and cost when prescribing.

Minimum Basic Income

Revisiting a minimum basic income for individuals with disabilities would allow them to access essential medications and other necessary items.

Study Limitations

1
Small sample size limited to people with SCIs in Canada.
2
Qualitative approach at one point in time, could not explore how these experiences changed over a period of time.
3
Interviews only conducted in English.

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