Prevention & Recovery

Do you really need that pill?

By: Danielle Martin, MD

Photography by John Hyrniuk Author: Canadian Living Credits: Photography by John Hyrniuk

Prevention & Recovery

Do you really need that pill?

By: Danielle Martin, MD

Every weekday afternoon, viewers across Canada tune in to Dr. Oz  for tips on how to stay healthy. He can often be seen promoting new supplements and vitamins that he insists will promote strong bones, ward off cancer or impart any number of other benefits. There is good medical evidence to support the use of some of these supplements. Vitamin D, for example, is in short supply in our northern climate, because our bodies make it with exposure to sunlight; most Canadians should take a vitamin D supplement, especially in the winter months.

Other supplements are of questionable value, but harmless – such as vitamin C, which our bodies simply dispose of through urine. But others can cause harm, either by overloading the body with substances it can't eliminate (too much vitamin A can be toxic, for example) or by interacting with medications we take or even the foods we eat.

The truth is, we can get just about all the nutrients we need the old-fashioned way: by eating a balanced diet with lots of vegetables and adequate fruit. (Most vitamin supplements cost a lot more than a trip to the produce section!) So why do we keep gravitating to the latest supplement trends? It's because we've been taught that the answer to any problem is as simple as finding the right tablet, capsule or dissolvable powder.

The problem extends well beyond vitamins and herbal supplements into prescription pills. From antidepressants to medication for high blood pressure, Canadians have never taken as many pills as we do today. In some cases these medications truly save lives; in others they're of questionable benefit or actually cause harm.

The increase in prescription drug use also has implications for our personal finances and for the collective piggy bank: Canadians spent a whopping $31.1 billion on prescription drugs in 2010. That's $910 for every man, woman and child in the country, including what is spent publicly through tax dollars, what private insurance pays and what each of us spends out of pocket. That's triple the amount spent per person 20 years ago; our annual growth in prescription drug costs is higher than in any other wealthy country, even the U.S.

In part, this cost increase is because we simply consume more drugs than before: In 2009, Canadian physicians wrote 80 percent more prescriptions than they did a decade earlier. But we also pay too much for our medications. We could drive harder bargains with pharmaceutical companies if we bought our medications in bulk, as many other countries do, or if our public and private plans covered expensive new medications only once they had been shown to improve on older, less expensive versions.

Though there is overuse of prescription medications and supplements in some segments of the population, there is underuse in others. Even with the amount of money the country spends on drugs, there are still many Canadians left behind. Recent studies have confirmed that one in 10 Canadians does not take medication as prescribed because of concerns about cost.

In most provinces, public drug plans take care of seniors and people on social assistance, and many people in steady jobs have coverage through employers. But up to eight million Canadians (or 23.5 percent), including many young people and people who are self-employed or work part time, have no prescription coverage at all. And when people can't afford necessary medicines, they end up in hospital, which drives costs even higher.

When medicare was first adopted, treatment by doctors and hospital stays were all that needed to be covered, because those were the main costs of health care. Today, many Canadians battle multiple chronic conditions and live longer lives, but our system hasn't adapted to this new reality. The notion that access to prescription meds should be based on need rather than ability to pay hasn't gained traction yet.

We don't have to accept this state of affairs: France, Australia and Sweden all have universal pharmaceutical coverage, and they pay far less for their drugs than we do.

Individual health rests not on this or that new pill or vitamin, but on living a healthy lifestyle. The same is true of our health-care system, which will achieve its full potential only when all the different parts are working together. A proper health-care system is one that provides coverage of necessary medications for the entire population – and at a price that doesn't break the bank.

Danielle Martin is a family physician in Toronto and the vice-president of Medical Affairs and Health System Solutions at Women's College Hospital.

If you want to know more about supplements, here's our guide on everything you need to know about vitamin D.

This content is vetted by medical experts

                                              
This story was originally titled "Pills, Pills, Pills" in the November 2013 issue.
           
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Prevention & Recovery

Do you really need that pill?

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