Leading causes of mortality and prescription drug coverage in Canada and New Zealand

Background Canada may soon see the introduction of a national pharmaceutical insurance system. New Zealand has a government-funded healthcare system used by all residents that operates within a tight cost-containment budget. Objective To compare the main mortality causes in Canada and New Zealand and examine listings in current Canadian provincial public drug plans and the New Zealand national drug formulary. Methods Age-standardized mortality rates from 1985 to 2014 and data on hospital discharges and average length of stay in hospital for Canada and New Zealand were obtained from the Organization for Economic Cooperation and Development’s website. Information on insured medications was obtained from Canadian provincial drug plan lists and the New Zealand Pharmaceutical Schedule current in mid-2019. Results Mortality rates for acute myocardial infarction, ischemic heart disease and cerebrovascular disease were higher, on average over the 30-year observation period, in New Zealand, but rates for malignancies and respiratory disorders were similar in the two countries. Reimbursement listing rates for drugs for cancer and some cardiovascular indications were lower in New Zealand than in Canada. Conclusions New Zealand’s drug coverage system has contained costs, but it restricts or denies access to new innovative medicines with the potential to improve patients’ lives. Although a New Zealand-style national pharmacare scheme in Canada would offer the opportunity to restrain drug expenditure, it would likely fail to satisfy patients and healthcare providers and diminish health outcomes, resulting in higher costs in other healthcare sectors.