Cowtown

What you need to remember is that you are not being hit with NIC payments to cover the cost of all of it. Plus your deductions from taxable income are greater in Canada.

Do you get to stay on your employers healthcare package while on maternity leave?

I much prefer the Canadian system. I'm sitting here with a broken tooth and facing a very large bill to fix it (even after the insurance) - I still dont want to go back to the UK and the NHS.

As for prescription drugs - I get stuff here that works - not the cheapest the NHS will prescribe.

Cowtown

What it costs to produce is actually irrelevant. They need to cover all of the other costs from the sales of the drugs - for example research and testing to produce the new drug in the first place!

$85 is fairly cheap for a certain inhalers. Ventolin you can get for roughly $12 but some of the others are easily $100each.

Biiiiink

We've done the dental debate, still not sure on what basis you think it's preferrable to be treated here rather than there...

...but what do you mean about drugs, is there something in particular you're thinking of? It's all the same stuff here as there. You're more likely to get a generic on the NHS but it's the exact same as a brand, just without the fancy packaging and advertising. And I'd rather not pay for those, don't know about you!

If you need something on the NHS, you get it for the universal prescription fee...your treatment is not based on the real cost of the drug to the NHS in any way.

Colsgirl, will PM tomorrow - he forgot to look it up today

Colsgirl

Hi Biiiiink,

I'll agree with what is being said here about the NHS prescribing the cheapest drugs. I have used Ventolin for 30+ years. You can tell the difference between a genuine Ventolin inhaler and a cheaper generic Salbutamol. I don't mean the quality of the drug inside, but the badly made plastic outerbody, aerosol bit keeps clogging even when washed regularly, cannister bit losing pressure before being finished.

I managed to persuade my GP to list it as the branded drug instead of the generic. Then the pharmacist decided to change it anyway. The only way I managed to get a ventolin inhaler was to get it on a private prescription - which worked out cheaper than an NHS one anyway!!!

Louise

Biiiiink

They don't prescribe the cheapest, I'm sure most GPs don't look at what stuff costs, it doesn't affect them or the treatment course they choose. They can only prescribe by the generic name for a drug however (which imho is the right thing to do, I'm slightly horrified at the brand-name advertising to the public here, never mind to doctors in the UK). What product you actually get at the chemist will depend on what deal/contract Lloyd or Boots or whoever you use has done with the manufacturers of those drugs. Sometimes you'll get a generic, sometimes you'll get a brand. Luck of the draw. Nearly all of the time a generic will be cheaper but as you've discovered, that's not the case with salbutamol. The generic costs 2.99 GBP and the brand name (Ventolin) only costs 1.50 GBP! This is the exception, I'm not exactly sure why it's half the price of the generic...probably because it's such an old drug.

I can't comment about the clogging, don't use inhalers myself, but I just checked the drawer here and we have 2 generics and 1 Ventolin, Mr B has never noticed a difference but admittedly he's not a regular user. Not that it matters now as you're in Canada but there is an exception to the generic-only UK script writing with regard to salbutamol --if you ask your doctor to specify "CFC-free", you can get Ventolin specifically as all of the generics contain a CFC-based propellant.

I was wondering if Cowtown had a specific medication in mind when he said he gets stuff that works, not the cheapest the NHS will provide. Certainly amongst my own friends there is the notion that US/Canadian drugs are more potent, which is wrong, it's all the same stuff, there aren't any products that exist here that don't in the UK - perhaps with the exception of some obscure cancer drugs whose clinical efficacy remains unproven, but that's another issue. I still laugh at my colleague who asked me to bring him back Tylenol as "it's so much better at clearing my headache than paracetamol" (!), and I remember when Advil first launched in the UK they based their whole advertising campaign on a glamorous flight attendent whose friends asked her to bring back Advil from her US trips (ahem, it's just ibuprofen in a pretty box at ten times the price!) as it was so superior...

Interesting topic though hope to PM you later with info.

TrishP

Totally agree - even medication prescribed by the vet for our moggie is the same!!

Posidrive

I was on the same regime back in the UK. In six months here I've not had to take a single Asmthma drug. Went back to the UK fro a week and was wheezing like a 100 a day smoker (never smoked in my life). Back to Calgary again and no problems at all.

This clean Canadian air is wonderful

sysclp

Our meds are close to $200/month between the two of us. My husband has had various insurance plans at the places he has worked. The first place had a $50 deductible and paid 80% after that (you pay up front and it reimburses you by check) plus you had to pay $40/month in premiums by payroll deduction. The second place they paid all the premious but otherwise it was the same as far as how and how much it paid. The current place if you get the basic coverage it is free but only covers 70% of the drug cost plus they have a card you can use at the pharmacy so you don't have to pay the covered part up front, just the difference. After a year you can upgrade to premium which cost $30/month but has a lot more coverage on many things including drugs at 100%. We upgraded since it pays for itself in the long run.

Don't forget that last year the government in Ontario added in a new tax for health care premiums, I think it is around $50/month but I can't remember.

Cowtown

I was referring to the fact that it is generally cheaper to pay the excessive dental bills here than to pay NIC on income in the UK. I wasnt trying to get into the UK vs Canadian dental treatment differences.

I was referring to specific drugs. It very much seemed to me that the doctor actively tried to keep the drugs bill down - try the cheapest drugs first and when that doesnt work and I'm really sick move on to the more expensive stuff. Year after year after year - same pattern. Doesnt happen any more as the Canadian doctor doesnt care what it costs - he asks if we have insurance and then hands out good stuff.

macadian

Medication is a BIG consideration here. I have a pre existing Asthma condition and guess I am around $800 - $1000 dollars per annum. Also have a health plan (another $800 per annum) which of course does not cover any medication I require which is Asthma related.

Top that off with horrendously expensive dental costs in Canada and its a big chunk to consider.

Like Posidrive I stayed on the same regime (asthma) but have noticed a huge difference in how my Asthma behaves...as long as I stay out of the GTA. My first few months here I spent in Toronto and have to say my Asthma got worse!
Now out here it's much better and some days get away with half my normal use of inhaler. Was back in the UK last week, and of course, lots of socialising with friends etc. Smoking in pubs there really did me in and although have been back a few days, still getting my lungs clear of it. Looks like Scotland, Northern Ireland and Wales are going 'Smoke free' as of March next year in public places, but England are still procrastinating...the 'raise buying ciggs to 18 years' suggestion being a sop to those criticizing them lagging behind the rest of the UK.. What a load of bollocks!

Well rant over...still worth the added expense re prescription drugs to be here...but would appear not to be a place to be if you get really sick and don't have a plan! I can but hope!

Biiiiink

No UK GP looks to see what various drugs cost, they don't care and neither should they. If they knew what stuff cost or if the cost had any impact on them, would Colsgirl's GP have been so difficult about giving her Ventolin at half the price of the other?! They're making clinical decisions not business ones...it's best practise to put someone on the lowest effective dose of whatever, not to overtreat from the outset as can happen here, especially when patients have seen the latest commercial on TV and think they know what they want. Mr B's sick of people coming in and asking for T3s and whatever, there's no indication for it, they just demand it because they believe it's "good stuff".

Not sure why your Canadian doctor asked about insurance, could be subtext for anything - are you working, etc etc. Surely that question could lead you to getting a cheaper medication depending on your answer, unlike the UK.

Cowtown

Its subtext for "you can afford this drug then". We all know a Canadian doctor will prescribe something you can afford to buy - no use giving out a prescription the patient cannt afford. Equally it goes the other way - if you can afford it you get "better" drugs.

Explain to me why, if the UK doctor is not prescribing cheap stuff first, why I would be repeatedly ill every year yet only after prescribing the same (ineffective) drug every year would the doctor prescribe something that would work.

I know from my/our prescription charges over here that the stuff that works cost $90 yet the stuff that is useless costs $12. I really dont believe that the UK doctors are unaware of the drug costs.

dbd33

I don't believe that is true of the doctor where I take the kids (the East End Community Health Centre). They're full of hints and tips on saving a buck at the pharmacist's and they save their free samples for people who have no plan, but that's after determining what drug is appropriate, not before.

iaink

No point prescribing a drug your patient cannot afford to get, especially when the benefit is marginal over something cheeper. Also, our doctor often has drug samples supplied by the sales reps, and generally he will only hand them out to those who need a free handout (ie no insurance low income, but not below the welfare trillium plan cutoff)

I am pretty sure there are prescribing guidelines and pressure from health managers in the UK to reduce costs, someone in the system knows what it all costs. Whether they are officially sanctioned I dont know, its probably a political minefield.

Steve_P

Firstly you will have to define "ill". If you are suffering form a cold or virus no prescription is really going to help that much, but I'm sure you know that.

Perhaps after being put on the first one that didn't work the second one only appeared to work because whatever ailed you had run its course.

Just a thought.