Patients receiving treatment for mental illness face multiple barriers to drug approval and access, study finds


A new study has found that patients receiving treatment for mental illness in Canada are waiting too long for medication to be approved and face inequitable access across the country.

A study by the Mood Disorders Society of Canada, called The Broken System, finds that Canadians who depend on public drug plans are particularly at risk.

As we face a widespread and growing mental health crisis, the need to change our broken system is clear, the report says. The insights detailed in this report indicate that there are inherent gaps in Canadians’ access to mental health medication that illuminate inequities, including time delays, and highlight how mental illness continues to be stigmatized in our society.

Once Health Canada determines that the drugs are safe and effective, private insurance plans help cover the cost of these prescriptions.

This study found that 42 percent of respondents rely on a public drug plan, an increase of three percent over 2015.

But it found that those patients can’t get access to the newly approved drugs until they go through another layer of bureaucracy, which starts with a health technology assessment that determines whether patients on a public drug plan are eligible for reimbursement.

The Canadian Agency for Medicines and Health Technology, known as CADTH, is responsible for this process in every province and territory except Quebec, where a similar quasi-governmental agency reviews new drugs.

Between 2012 and 2022, CADTH gave a negative rating to 54 percent of mental illness drugs, far more than the 17 percent negative ratings given to non-mental illness drugs.

The study excluded oncology drugs.

One of the problems is that (CADTH) doesn’t have a psychiatrist on the committee, said Dr. Pierre Blier, director of mood disorder research at the Royal Center for Mental Health in Ottawa.

The report says these negative ratings from both CADTH — and its Quebec equivalent INESS, which gave a 62 percent negative rating — mean those on public drug plans are not being reimbursed, making them more expensive. .

So people who can’t afford them won’t be able to take these drugs, Blier said.

CADTH would not speak to CTV News about the study. However, Health Canada said the government is “committed to protecting Canada’s drug supply and ensuring that Canadians have access to the drugs they need.”

Access to medication and the costs associated with it is something that worries 28-year-old Ottawa student Chelsea Meldrum.

“I started self-harming and suicidal idealization at age 12,” said Meldrum, who treats schizophrenia by taking more than ten pills a day.

I have several antipsychotics, which help me with my paranoia, my delusions, she said.

Meldrum credits these drugs with keeping her in touch with reality enough to earn a degree in health psychology from Carleton University.

She currently has a private plan through her mother, but if she wants to move to her own place, that coverage will end.

I’m just worried if I go, will I be able to afford the medicine, she said.

The report estimates that mental illness costs the Canadian economy about $50 billion a year.

Blier said that when those struggling with mood disorders are denied access to medication, society as a whole suffers.

Doctors are often unable to use their first choice of drugs for patients because those drugs are not available. In situations where patients do not respond to various drugs, we have to switch to some of the newer drugs, he said.

“But because they’re not covered by government plans, patients can’t access them and we have to go to different additional strategies that are not the preferred treatment strategy.”

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