And the Grade is … Poor! Provinces Receive Failing Grade While Canadians Continue to Wait for New Medications to Treat Their Depression

OTTAWA, ON, June 16, 2020 /CNW/ - Canadians living with depression — but without access to private health plans — are not getting the help they need from either Canada's national not-for-profit body that recommends drugs for public health coverage or from their own province, which is responsible for health care delivery. In fact, when it comes to ensuring timely access to medications, government performance gets a failing grade.

Canadians with major depression have been waiting for governments to act and provide coverage for new alternative depression medications. Now, amidst a COVID-19 pandemic, public opinion research reveals that more and more Canadians are dealing with mental health problems — evidenced by a jump in calls to crisis lines, mental health professionals, and core service providers. The Centre for Addiction and Mental Health (CAMH) reports that one-quarter (25.5%) of respondents to a survey conducted May 8-12 indicated moderate to severe anxiety levels and one-fifth (20.4%) indicated feeling depressed occasionally or most of the time in the past week. Of the respondents, 24.5% of females and 16.3% of males have experienced increased levels of depression.

New, innovative medications provide us with effective alternatives in treating a complex illness such as depression, which has 227 different combinations of symptoms, is the leading cause of disability around the world, and affects productivity. "The 40 percent of people with depression who don't respond to the standard medications need access to a variety of medications," said Dr. Sidney Kennedy, professor of psychiatry at the University of Toronto, and the Arthur Sommer Rotenberg Chair in Suicide and Depression Studies.

Having access to new innovative depression medications is crucial, yet a ground-breaking national report card issued by the coalition of Canadians for Equitable Access to Depression Medications (CEADM) highlights the huge access gap for millions of Canadians. CEADM retained Nanos Research, one of Canada's leading public opinion and research firms, to produce the comprehensive report card.

Despite all the federal, provincial and territorial mental health strategies and federal health transfers to each province that are designated specifically for mental health, not one strategy mentions medications — one of the pivotal elements of treatment and care. On this and other dimensions, provinces and territories right across the country fail.

On a national level, Canada fails on two fronts:

• 30% of new medications are not covered in public drug plans
• the number of new, innovative drugs that are being recommended for public drug plan coverage
• it's taken 16 long years for the Canadian Agency for Drugs and Technologies in Health (CADTH) to finally recommend, in mid-February 2020, one new depression medication for listing on provincially funded drug plans

While the amount of time it takes to have a drug recommended for public plan coverage has decreased from the average wait time of 340 days, there is still room for improvement.

Canada also fails jurisdictionally. As part of the development of CEADM's national report card, Nanos Research conducted a gap analysis of the range and scope of depression medications offered across the country. Canada's provinces and territories, which are responsible for public drug plan coverage, score poorly across the board, with some receiving a poor mark (highest grade given) and others a bad mark (worst grade given). The gap analysis examined:

• the number of generic and brand-name drugs covered by provincial drug plans
• in general, 70% of generic and brand-name medications are not covered, and those that are covered are older medications that may not work for or may not be tolerated by everyone with depression
• the pricing of depression medications
• most provinces won't cover new innovations because they only cover cheaper medications through a maximum reimbursable price or lowest-cost alternative policy
• the type of treatment and services provided to Canadians by individual jurisdictions
• all provinces have a mental health strategy, but what is included widely varies from jurisdiction to jurisdiction and fails to value patient-centred care

"The provinces and territories are not meeting the needs of all their citizens who are struggling with depression and depend on their provincial drug plan to access the medications they need to be mentally well," says Dave Gallson, CEADM Co-Chair and National Executive Director of the Mood Disorders Society of Canada. "Canadians deserve access to the new medications as effective alternatives to treat their depression. The provinces have to include looking at medication as part of their mental health strategy. Furthermore, the brand-name medications that are covered under a province's public drug plan are old medications that just don't work for all Canadians."   

"I am hopeful that CADTH's recent decision to recommend for listing a new, innovative depression medication for the treatment of major depression is an acknowledgement that one size of treatment does not fit all," said Dr. Kennedy.

"As highlighted in the 2016 CANMAT guidelines, pharmacological management of major depressive disorder still depends on tailoring treatments to the patient. These treatments must include the latest depression medications, which are critical when it comes to treating people with mental illness," adds Dr. Kennedy, a co-author of the guidelines.

CEADM Co-Chair Brianne Moore, who lives every day with major depression, knows the effects first-hand of Canada's failure to provide access to the latest medications on public drug plans. "Many anti-depressants didn't work for me; the symptoms only got worse. It was only a few years ago that I was prescribed a new medication that has stabilized my illness. Now that I am no longer on my parents' drug plan, I face a negative outcome whichever way I look at it — paying for medication that works or putting food on the table."

Because only a limited number of medications to treat depression are covered by provincial public drug plans, "inequitable access affects the most vulnerable populations in our society," adds Ms. Moore. "One approval for a new innovative depression medication in 16 years is unacceptable. Neither is the fact that provinces talk a strong game regarding mental health supports but aren't following through with comprehensive supports that include access to the latest medications."

CEADM commissioned Nanos Research to undertake a scan of provinces and territories to identify gaps in mental health treatment, and to survey Canadians about the importance of providing public plan coverage for the latest depression medications. "Most Canadians we polled — in fact, eight out of 10 — say that equal access to these innovative medications is important, and should be a priority of the federal and provincial/territorial governments," says Nik Nanos, president of Nanos Research.

SOURCE Canadians for Equal Access to Depression Medication (CEADM)

Media Contact: Joan Weinman, 613-294-5679, [email protected]