Senior Access to Medications: Why It’s Difficult in Canada and What Can Be Done

by Cheryl Petruk, MBA

Canada prides itself on a publicly funded healthcare system designed to ensure equitable access to care for all citizens. However, for many seniors, access to necessary medications remains a persistent and complex challenge. While doctor visits and hospital stays are largely covered under the Canada Health Act, prescription medications—especially those taken outside of a hospital setting—are often not. This leaves seniors, many on fixed incomes, navigating a confusing patchwork of provincial drug plans, rising out-ofpocket expenses, and bureaucratic approval processes. This article explores the major barriers seniors face in accessing medications in Canada and discusses how systemic reform and patient advocacy can help alleviate this growing concern.

1. Financial Barriers and the Cost of Prescription Drugs

Perhaps the most prominent barrier to medication access for seniors in Canada is cost. While every province and territory offers some form of drug coverage for seniors, the specifics vary widely. Deductibles, co-pays, and eligibility requirements mean that many older adults still face significant out-of-pocket expenses.

For example, under Ontario’s Ontario Drug Benefit (ODB) Program, seniors must still pay a $100 annual deductible and $6.11 per prescription—amounts that can quickly add up for those on multiple medications. In provinces like British Columbia and Alberta, income-based plans may result in higher costs for seniors with modest retirement income, which nonetheless disqualifies them from full coverage.

The result? Many seniors report skipping doses, splitting pills, or delaying prescription refills. A 2018 study published in Health Affairs found that nearly 1 in 10 Canadians aged 55 and older said they did not take their medications as prescribed due to cost.

2. Fragmented and Inconsistent Drug Coverage Across Provinces

Canada does not have a universal pharmacare program. Instead, each province and territory administers its own public drug plan, creating inconsistencies in access and affordability A medication approved and fully covered in Quebec may not be accessible to a senior in Manitoba without significant personal cost

This fragmentation results in inequality not just by income, but by geography. Seniors living in rural and remote areas, particularly in Indigenous communities, may also struggle with additional logistical barriers such as fewer local pharmacies and delayed delivery services. Moreover, provincial drug formularies may not include all necessary medications, particularly new or highcost drugs.