Health·Blog

Drug discount-card users write CBC, showing patients' perspective — and then some

I now have personal health information for more than 70 Canadians, along with their names, emails, and the prescription drugs they’re taking. All of those people have one thing in common. They used a drug discount card and registered with the card company.

Emails sound more like call for national pharmacare than an endorsement of discount cards

Patients send pre-addressed emails to CBC from drug card company (CBC)

I now have personal health information for more than 70 Canadians, along with their names, emails, and the prescription drugs they're taking.

All of those people have one thing in common. They used a drug discount card and registered with the card company. 

If there was ever any doubt that corporations would use the patient information they gathered from these cards for marketing purposes, this is a vivid illustration that they will.

Dozens of emails appear

It started with a story I wrote last week about the prevalence of prescription drug discount cards. Doctors give the cards to patients along with their prescriptions. The cards are also available from pharmacies and online.

If the patient uses the card to buy a brand name drug rather than a lower-cost generic version, the drug company will pay part or all of the difference in price.

It would be a matter of choosing food or prescriptions.- Patient email to CBC

Innovicares, a program run by STI Technologies, is one of two Canadian companies that manage the cards for the large pharmaceutical companies. STI Technologies receives a fee from the drug companies every time a card is used.

When our story ran last week, the folks at STI's head office in Halifax felt that the patient perspective was not reflected.

So they sent personally addressed emails to their cardholders, encouraging them to write to me. The company attached an email form, conveniently pre-addressed, with the subject line already filled in.  All the patient had to do was add their personal story.

Soon dozens of emails with the subject line "Patients are part of the equation" began filling my in-box.

"They could at any point stop that coverage." - Tim Gillis, CEO, STI Technologies Ltd.

I read every email. And they were quite compelling, but not for the reasons the company might have intended.

The patient stories read like postcards from a land of drug cost desperation.

"As a senior on a fixed income, without these cards I would not be able to afford my prescriptions. It would be a matter of choosing food or prescriptions," one person wrote.

"The drug cards have saved me from a crippling illness and financially crippling drug costs," another person wrote.

 "l am glad that somebody out there helps us pensioners," wrote one elderly man.

Dozens of people told sad stories about their dependence on the largesse of drug companies, which offer these discounts as a way of holding on to market share.

And it's a discount that can end at any time.

"There's no guarantee, that's clear on our website," Tim Gillis, chief executive of STI Technologies said. "Whether or not a pharmaceutical company wants to offer a financial benefit for a particular drug is completely up to their discretion. They could, at any point, stop that coverage."

Gillis estimates that one million Canadians now have a drug discount card. He says his company processes 20,000 transactions every day.

"We believe we're helping patients," Gillis said, even though the true customers are the drug companies.

"They're the clients, they pay the bills, absolutely," he said.

Call for national pharmacare?

It's clear that patients are grateful for the discounts. 

But their emails sounded more like a call for a national pharmacare program than an endorsement of drug discount cards.

 "I have a hard time understanding why drugs that would be beneficial to an individual would be so costly," one person wrote.

"If the drug companies could lower their price, or better still, the government cover all drugs for seniors, we would not have a problem," one woman wrote.

Some said they realized they were part of a marketing campaign.

"Do we know that the company exists to sell its product? Of course we do," one woman wrote. "But when you can't take a generic drug, and your insurance company won't cover the cost of the name brand drug, what are you suppose to do?  Some people simply can't afford to pay the difference themselves."

Many people said they were using more expensive brand name drugs because they'd had problems with the lower cost generic versions. And they turned to the drug discount cards because their drug plans won`t cover the extra cost.

However, many insurance plans will pay for brand name drugs if a doctor declares them to be medically necessary, according to an insurance industry analyst who has studied the discount cards.

We  honestly thought it would do you good to hear their stories.- Tim Gillis, CEO, STI Technologies Ltd.

Ontario's drug program will also pay for medically necessary brand drugs, if the patient presents a form from the doctor when filling the prescription, according to a spokesperson from the Ontario Ministry of Health.

Gillis says it's all about patient choice. It's their choice to use the drug discount cards. It's also their choice to use brand name drugs over generic alternatives.

But if the patient claims are true, how much choice do they truly have, if the discount card genuinely relieves them of making a choice between medicine and food?

When I asked Gillis why his company prompted so many patients to write to CBC, he said: "We honestly thought it would do you some good to hear their stories."

 He's right.

The emails paint a clear picture that, without a national pharmacare program, many Canadians are forced to depend on drug company discounts to help cover the sometimes crippling cost of prescription drugs.

About the Author

Kelly Crowe

Medical science

Kelly Crowe is a medical sciences correspondent for CBC News, specializing in health and biomedical research. She joined CBC in 1991, and has spent 25 years reporting on a wide range of national news and current affairs, with a particular interest in science and medicine.

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