Patients treated for mental illness face more barriers for medication approval and access, study finds

A pharmacy worker counts pills for a prescription in Montreal, Thursday, March 11, 2021. (THE CANADIAN PRESS/Ryan Remiorz/FILE)

OTTAWA -

A new study has found that patients being treated for mental illness in Canada wait “far too long” for medication approval and face “inequitable access” across the country.

The study from the Mood Disorders Society of Canada, titled “System Broken,” finds Canadians who depend on public drug plans are especially disadvantaged.

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“As we face a widespread and growing mental health crisis, the need to change our broken system is clear,” the report says. “The insights detailed in this report indicate that there are inherent gaps in Canadians’ access to medications for mental illnesses – gaps that illuminate inequity, including time delays, and highlight how mental illness continues to be stigmatized in our society.”

Once Health Canada determines if medications are safe and effective, private insurance plans help cover the cost of these prescriptions.

This study found 42 per cent of those surveyed rely on a public drug plan, a three per cent increase since 2015.

But it found those patients can’t get access to newly approved drugs until they make their way through another layer of bureaucracy, which starts with a health technology assessment that determines if patients on public drug plans are eligible to be reimbursed.

Canada’s Drug and Health Technology Agency, known as CADTH, is responsible for this process in every province and territory except Quebec, where a similar quasi-governmental agency reviews new drugs.

Between 2012 and 2022, CADTH gave a “negative assessment” to 54 per cent of mental illness medications, far higher than the 17 per cent of negative assessments given to non-mental illness drugs.

The study excluded oncology drugs.

“One of the problems is that (CADTH) have no psychiatrists on the committee,” said Dr. Pierre Blier, director of the Mood Disorder Research at the Royal Ottawa Mental Health Centre.

The report says these negative assessments from both CADTH -- and its Quebec equivalent INESS, which gave 62 per cent negative assessments -- mean those on public drug plans aren't getting reimbursed, making them more expensive.

“So people who can't afford them won't be able to take these medications,” said Blier.

CADTH would not speak with CTV News about the study. However, Health Canada said the government "is committed to safeguarding the Canadian drug supply and ensuring Canadians have access to the drugs they need.”

The access to medication, and the cost associated with it, is something that concerns 28-year-old Ottawa student Chelsea Meldrum.

“I started self-harm and suicidal idealisations at age 12,” said Meldrum, who manages Schizophrenia by taking more than a dozen pills a day.

“I have a few anti-psychotics, which help me with my paranoia, my delusions,” she said.

Meldrum credits these medications with keeping her in touch with reality enough to pursue a degree in health psychology at Carleton University.

She’s currently on a private plan through her mother, but if she wants to move into a place of her own, that coverage will end.

“I'm just worried if I do leave, if I'm going to be able to afford the medication,” she said.

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The report estimates mental illnesses cost the Canadian economy about $50 billion per year.

Blier said when those who struggle with mood disorders are denied access to medications, all of society suffers.

“Doctors are often not able to use their first choice of medication for patients because those medications are not accessible. In situations where patients are non-responsive to a variety of medications, we have to go to some of the newer medications,” he said.

"But because they are not covered by government plans, patients cannot access them, and we have to go into different supplemental strategies that aren’t the preferred treatment strategy."