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By publicly funding essential medicines and covering the cost of nearly half of all prescriptions in Canada, $3 billion per year will be saved while removing financial barriers for Canadians. “Universal pharmacare has been long-promised but undelivered in Canada, in part because of concerns about where to start,” said Steve Morgan, a professor in the school of population and public health. “We show that adding universal public coverage of essential medicines to the existing system of drug coverage in Canada is a significant and feasible step in the right direction.” A list of 117 essential medicines were identified by researchers including, antibiotics, insulin, heart medication, anti-depressants, oral contraceptives and more. They found that the list accounted for 44 percent of all prescriptions written in 2015 and up to 77 per cent of all prescriptions when therapeutically similar medications were considered. According to The World Health Organization (WHO) these essential medicines should be provided to everyone who needs them. Dr. Persaud, a family physician, leading the team developing the essential medicines list, said the WHO’s list has been adapted based on clinical practice in Canada. Currently, Canadians depend on a mix of private and public coverage leaving millions facing high out-of-pocket costs for drugs. Research shows that due to the high out-of-pocket costs which many Canadians cannot afford, many do not take medication as prescribed. “Access to medicines can be the difference between life and death,” said Dr. Nav  Persaud. “There are treatments for HIV and heart disease that save lives but only when they are in the hands of people who need them.” Morgan and Dr. Persaud propose governments purchase these essential medicines in bulk for all of Canada. They believe this approach will save patients and private drug plans $4.3 billion per year while costing government only an additional $1.2 billion per year. This would lead to a total net savings of $3.1 billion per year for Canadians. “A program of this kind is a feasible way of improving the overall health of Canadians while dramatically lowering drug costs,” said Morgan. “Other countries that do similar things pay 40 to 80 per cent less for these essential medicines.” Dr. Persaud is leading a clinical trial with patients in four Family health Teams in Ontario. Through these trials he will compare the health outcomes and health-care use of people receiving the free essential medicines and those who did not.
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Society
According to a new forecasting tool developed by a UBC researcher and industry collaborator, around one-quarter of detached homes in Vancouver’s hot housing market could be demolished between now and 2030.   This forecasting tool, called the teardown index, reveals that the lower the value of the residence relative to the value of the overall property (its relative building value, or RBV), the house is more likely to be torn down and replaced. “An RBV of between 60 per cent and 70 per cent is generally considered healthy for a new building. But when a building is worth less than 10 per cent of the total value of the property, the probability of teardown and replacement increases dramatically,” said Joseph Dahmen, a professor of architecture at the University of British Columbia and a Wall Scholar at UBC’s Peter Wall Institute for Advanced Studies. To illustrate this point, the researcher traced the RBV of a house constructed in 1940. It revealed that with the increase in the overall price of the property over 75 years, its relative building value decreased until it hit a low point of 4 percent. According to Dahmen, with such a low RBV, there is a 50:50 chance the house will be torn down by the new owner, and a new house will be built more in line with the overall price of the property. According to research collaborator and mathematician Jens von Bergmann of MountainMath Software, with the recent surge in Vancouver real estate values, half of single-family homes in Vancouver have RBVs below 7.5 percent. “If RBVs continue to slide, one-quarter of all single-family homes will be torn down between now and 2030, replaced by new single-family houses that seek to maximize size,” said von Bergmann. “It’s not clear how that will help affordability. We should ask ourselves how to replace these teardowns with more units of ground-oriented, family-friendly homes on each lot.” Given that a quarter of all-single-family homes sold in Vancouver proper are torn down and replaced, researchers are contemplating on using their findings to gauge the projected environmental impact of the new homes. “As building operations become more efficient, materials will account for an even larger share of overall environmental impacts. Focusing on the materials as well as energy efficiency would improve RBVs while helping to break the cycle of demolition and construction in Vancouver,” said Dahmen. teardown_graphic_1.png.jpg    
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