Engaging physicians to prescribe more cost-effectively: Blueprint for change

The cost of pharmaceutical spending in Canada continues to rise with concerning rapidity. In 2018 it was the fastest growing category of health care expenditures, at a rate of 3.2% per capita per year. Earlier estimates put total health care spending in 2018 at $253 billion, of which 15.7% was expected to be spent on drugs. Canadians spent approximately $13.1 billion dollars out of pocket on prescription drugs in 2018. Controlling drug costs allows for an improved allocation of resources to other essential aspects of health care. Physicians' ongoing lack of awareness of drug costs remains a substantial obstacle to controlling spending on pharmaceuticals. Two of us (i.G. and J.R.L) previously have encouraged mandating drug cost transparency but have not yet described the different levels through which this could be implemented. Here the authors explore potential cost savings resulting from 3 progressively more informative methods of implementing drug cost transparency for physicians when prescribing through electronic health records in real time. In these models, drug costs would automatically appear to prescribing physicians at the point of writing a prescription and would use publicly available provincial drug formulary costs.