Effects of the COVID-19 pandemic on the number and characteristics of public drug program beneficiaries in Ontario, Canada

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Effects of the COVID-19 pandemic on the number and characteristics of public drug program beneficiaries in Ontario, Canada

Zachary Bouck, Daniel McCormack, Mina Tadrous, J. Michael Paterson, Tonya Campbell, Tara Gomes

ABSTRACT               

Introduction: In March 2020, the provincial government of Ontario, Canada enacted emergency public health measures to limit SARS-CoV2 transmission, including non-essential service closures, which contributed to substantial job and earnings losses. Concurrently, the federal government introduced temporary income benefits for Canadians with lost earnings due to COVID-19. We evaluated the collective effects of the COVID-19 pandemic, provincial emergency measures, and temporary federal income benefits on the number of Ontarians qualifying for public prescription drug insurance as provincial social assistance recipients over time. Methods: Using administrative data from January 2019–March 2021, we conducted interrupted time series analyses of Ontario Drug Benefit (ODB) beneficiaries aged <65 years qualifying as Ontario Works (OW) or Ontario Disability Support Program (ODSP) recipients. We used segmented regression models to estimate joint effects of the COVID-19 related interventions, which were first implemented in March 2020, on the monthly number of ODB beneficiaries receiving OW or ODSP benefits. Senior ODB beneficiaries (all Ontario residents aged ≥65 years) were analyzed separately as a control series. Results: Post-implementation, the interventions were associated with an immediate absolute increase in the number of ODB beneficiaries qualifying via OW (19,025; 95% CI=9,265–28,784) and gradual absolute reductions in the number of ODB beneficiaries qualifying through OW (-5,680 per month, on average; 95% CI=[-7,857]–[-3,502]) or ODSP (-1,993 per month, on average; 95% CI=[-2,500]–[-1,486]) beyond pre-implementation trends. Overall, the interventions were associated with 49,135 fewer OW beneficiaries (95% CI=[-75,175]–[-23,095]) and 20,356 fewer ODSP beneficiaries (95% CI=[-26,821]–[-13,891]) than expected in March 2021 had the interventions not occurred. The interventions were not associated with meaningful changes in the senior (control) series. Conclusions: Despite job and wage losses due to the pandemic, we observed gradual and overall decreases in the number of ODB beneficiaries qualifying as social assistance recipients in the first year of the COVID-19 pandemic, presumably due to the introduction of temporary federal income supports to help workers recover lost earnings. Further research should examine how withdrawal of federal income supports may have contributed to subsequent gaps in public drug coverage among low-income adults and families in Ontario.

Authors credentials and affiliations:

Z Bouck PhD1,2, D McCormack MSc3, M Tadrous PhD1,2,3, J M Paterson MSc 3,4,5, T Campbell MPH2, T Gomes PhD1,2,3,4

  1. Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
  2. Li Ka Shing Knowledge Institute of St. Michael’s Hospital, Unity Health Toronto, Toronto, ON, Canada
  3. ICES, Toronto, ON, Canada
  4. Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
  5. Department of Family Medicine, McMaster University, Hamilton, ON

Corresponding author:  Tara Gomes tara.gomes@unityhealth.to 416-864-6060 x77046 30 Bond St., Toronto, ON, Canada. M5B 1W8

Acknowledgments: This study was funded by the Ontario Ministry of Health (Grant # 0691). This study was also supported by ICES, which is funded by an annual grant from the Ontario Ministry of Health (MOH) and the Ministry of Long-Term Care (MLTC). Parts of this material are based on data and information compiled and provided by the Ontario Ministry of Health, the Ontario Ministry of Children, Community and Social Services, and the Canadian Institute for Health Information. We thank IQVIA Solutions Canada Inc. for use of their Drug Information File. This document used data adapted from the Statistics Canada Postal CodeOM Conversion File, which is based on data licensed from Canada Post Corporation, and/or data adapted from the Ontario Ministry of Health Postal Code Conversion File, which contains data copied under license from ©Canada Post Corporation and Statistics Canada. The analyses, conclusions, opinions, and statements expressed herein are solely those of the authors and do not reflect those of the funding or data sources; no endorsement is intended or should be inferred. The authors report no conflicts of interest.

Data sharing statement: The dataset used in this study is held securely in coded form at ICES. While legal data sharing agreements between ICES and data providers (e.g., healthcare organizations and government) prohibit ICES from making the dataset publicly available, access may be granted to those who meet pre-specified criteria for confidential access, available at www.ices.on.ca/DAS (email: das@ices.on.ca). The full dataset creation plan and underlying analytic code are available from the authors upon request, understanding that the computer programs may rely upon coding templates or macros that are unique to ICES and are therefore either inaccessible or may require modification.

Status: Peer reviewed.

Submitted: 02 JUL 2024 | Published: 22 JUL 2024

Citation: Zachary Bouck, Daniel McCormack, Mina Tadrous, J. Michael Paterson, Tonya Campbell, Tara Gomes (2024). Effects of the COVID-19 pandemic on the number and characteristics of public drug program beneficiaries in Ontario, Canada. Canadian Health Policy, JUL 2024. https://doi.org/10.54194/GVUQ2702. canadianhealthpolicy.com.