Black people in Canada less likely to fill medication prescriptions due to cost, study says

A technician counts pills in a pharmacy laboratory, Wednesday February 5, 2025. THE CANADIAN PRESS/Jacques Boissinot

TORONTO — A new study says the cost of medication is stopping Black people in Canada from filling their prescriptions at a higher rate than white people.

The research published Monday in the Canadian Medical Association Journal found that Black people are less likely to have drug plans to cover the cost.

Senior author Bukola Salami says the findings show the consequences of socioeconomic inequalities for Black people’s health.

The researchers analyzed data from five years of the Canadian Community Health Survey and found that about 10 to 15 per cent of Black adults hadn’t filled their prescriptions or had skipped doses, compared to about six per cent of white adults.

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Salami, who is the Canada Research Chair in Black and racialized people’s health at the University of Calgary, says even when the researchers controlled for variables such as income and insurance coverage, Black people were still less likely to fill prescriptions.

She says a possible reason for that could be factors that weren’t part of the data they analyzed, including distrust of the health-care system because of direct or systemic racism.

“I think this points us to very, very important questions related to the need for equity in medication drug coverage,” Salami said in an interview.

“When we think about Canada, we say, you know, we have universal health care — but universal health care that does not include prescriptions,” she said.

The data was collected before the national Pharmacare Act was passed in 2024. The federal government has so far negotiated agreements to cover diabetes medication and birth control in British Columbia, Manitoba, Prince Edward Island and Yukon. The rest of the provinces and territories don’t yet have pharmacare agreements with the federal government.

Salami said more research will be needed to see if pharmacare improves access to prescription medication for Black people.

About 72 per cent of Black adults had drug insurance coverage, compared to about 80 per cent of white adults, the study found.

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The Canadian Community Health Survey is conducted annually by Statistics Canada and the researchers used data from the years 2015, 2016, 2018, 2019 and 2022.

They excluded 2017, 2020 and 2021 because the surveys didn’t have all the data they needed in those years.

Dr. Mojola Omole, president of the Black Physicians Association of Ontario, said the findings raise “a really important issue.”

Omole, who was not involved in the study, said she sees a large number of Black and racialized patients as a breast surgical oncologist at Scarborough Health Network and the issue of not being able to afford medication comes up “all the time.”

“If people have to pick between their medication and feeding their families, they’re going to pick feeding their families,” Omole said.

“This is a reality for a lot of people who are, whether they’re new immigrants or just coming from a working-class background, this is a huge issue for them.”

The study’s finding that Black patients with insurance were still less likely than white patients to get their medications could be explained by “distrust that Black and racialized folks in our communities have in the medical system,” Omole said.

“We have had such long periods where Black communities have not received great care and even to this day, many have horrific stories of what’s happened to them in terms of the pervasiveness of anti-Black racism.”

The primary care shortage adds to the problem, she said.

“When people are not able to form relationships with their physician because they don’t have a family physician — they’re using episodic care — it makes it more challenging to be able to say, ‘OK, you know what, this person knows me ... I trust them in terms of taking this medication,” Omole said.

This report by The Canadian Press was first published March 23, 2026.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

Nicole Ireland, The Canadian Press