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

OTTAWA –

A new study finds that patients treated for mental illness in Canada are waiting far too long to get drug approval and face inequitable access across the country.

The Mood Disorders Society of Canada’s study, System Broken, finds that Canadians who rely on public drug plans are at a particular disadvantage.

As we face a widespread and growing mental health crisis, the need to change our broken system is clear, the report says. The information detailed in this report indicates that there are inherent gaps in Canadians’ access to medications for mental illness, gaps that highlight inequities, including delays, and highlight the extent to which mental illness continues to be stigmatized in our society.

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

This study reveals that 42 percent of respondents rely on a public drug plan, an increase of 3 percent since 2015.

But the study found that these patients cannot gain access to newly approved drugs until they go through another level of bureaucracy, which begins with a health technology assessment that determines whether patients benefiting from a public drug insurance plan are eligible for reimbursement.

The Canadian Agency for Drugs and Technologies in Health, 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 review to 54 percent of drugs intended for mental illness, a figure far higher than the 17 percent negative reviews given to drugs intended for purposes other than mental illness .

The study excluded oncology drugs.

One problem is that CADTH doesn’t have any psychiatrists on the committee, said Dr. Pierre Blier, director of mood disorders research at the Royal Ottawa Mental Health Centre.

The report says these negative ratings from CADTH — and its Quebec equivalent, INESS, which gave 62 percent negative ratings — mean that people on public drug plans are not not reimbursed, which makes them more expensive.

So people who can’t afford it won’t be able to take these medications, Blier said.

CADTH would not discuss the study with CTV News. However, Health Canada said the government is “committed to protecting Canada’s drug supply and ensuring Canadians have access to the medicines they need.”

Access to medications and the associated costs worry Chelsea Meldrum, a 28-year-old student from Ottawa.

I started self-harming and having suicidal idealizations when I was 12, said Meldrum, who manages schizophrenia by taking more than a dozen pills a day.

I have some antipsychotics, which help me with my paranoia, my delusions, she says.

Meldrum believes these medications allowed him to stay in touch enough with reality to pursue a degree in health psychology at Carleton University.

She is currently on a private plan through her mother, but if she wants to move into her own place this cover will end.

I just worry if I leave, if I will be able to afford the medicine, she said.

The report estimates that mental illness costs the Canadian economy approximately $50 billion per year.

Blier said that when those suffering from mood disorders are denied access to medication, society as a whole suffers.

Doctors are often unable to use their first choice of medications for their patients because these medications are not accessible. In situations where patients do not respond to various drugs, we have to resort to some newer drugs, he said.

“But because they are not covered by government plans, patients cannot access them, and we have to resort to different complementary strategies that are not the preferred treatment strategy.”