There's no algorithm that makes a precise calculation of the consequences of forgone access to drugs among those Canadians who cannot afford to fill prescriptions. We do know from various surveys that it's not a huge portion, but there is a critical mass of Canadians who actually say they do not fill or renew prescriptions because they simply cannot afford to. We do know that there are downstream costs to the health care system, incremental costs associated with that. We would note from any of these studies that have been done that they are likely larger than the costs associated with providing drug coverage for those individuals.
Yes, there are downstream costs in terms of deteriorating health, possible admission to hospital, and utilization of other health care services. I think it's actually the reason that now, as you know, under the discussions about a shared health agenda and the potential of a new health accord, access to pharmaceuticals is one of the key components of that effort. There is a lot of concern about both the cost implications and the toll that it's taken on the health of those individuals who simply cannot afford drugs.
The people we're talking about are individuals who do not qualify for provincial/territorial public drug plans, which are mainly focused on older Canadians or people on social assistance. We are talking about people whose employment status is such that they don't have access to private insurance. There's that still quite sizable portion of the population who pay out of pocket for their own drugs. And a portion of those people—about a quarter of the total, some smaller portion, but nonetheless a significant portion—simply cut back on drugs that they should otherwise be using.