As a result of my crash injuries, I require injection therapies that will be ongoing, potentially for the rest of my life. As time goes on, much like the cost of groceries and gas, it is expected that the cost of those therapies will increase. Do the courts make an allowance for that when determining compensation?
The plaintiff In the recent case of Picton v Fredericks (2016 BCSC 1470) was suffering from ongoing headaches requiring botox injections at an interval of approximately every three months. It was the evidence of the plaintiff’s treating neurologist that the botox injections were an effective treatment that was appropriately administered quarterly. The plaintiff set out the total annual cost of the medication and injection fees for this treatment and provided a present value of the cost as determined by an economist. The defence argued that the frequency sought by the plaintiff was generous. Justice Williams accepted the plaintiff’s evidence with regards to the frequency and cost. In addition, when calculating the award, Justice Williams factored in a contingency for inflation of costs and fees for the treatment.
 Ms. Picton has been availing herself of this treatment since late 2013. The evidence of Dr. Robinson, Ms. Picton’s treating neurologist, addresses the necessity and efficacy of the treatment and the costs going forward. I accept his evidence that it is an effective treatment and is appropriately administered quarterly. I also accept the cost as set out by the plaintiff in her submissions—namely, a total annual cost of the medication of $3,217 and the injection fees ranging between $400 and $480.
 In his submission, I understood the defendant to suggest that, even if Botox treatments were needed, the frequency sought by the plaintiff was generous.
 With respect, I am not persuaded that is the case. As I indicated earlier in these reasons, I accept that the plaintiff’s headache condition is a serious problem. My analysis of the claims she has advanced and the awards I have determined to be appropriate are premised on the proposition that she will receive meaningful, effective care for her headache condition.
 The plaintiff also seeks other awards under this head to provide for massage therapy, physiotherapy, or kinesiology treatments. As well, she seeks to be awarded a sum based upon an annual cost for medication of $50.
 While I am prepared to make an award that fully meets the claim for the Botox treatment, in my view, the practical reality is that a more modest award should be made to cover whatever physical therapy Ms. Picton may see fit to engage and to provide for the medication. I conclude that $250 per year will satisfy those needs.
 In the result, I consider a proper award under this head to provide the sum of $3,947 per year for the plaintiff, on an indefinite basis.
 The plaintiff tendered the evidence of Mr. Darren Benning, an economist, providing the present value of that cost. He states that for Ms. Picton, the lump sum present value is determined by applying a multiplier of 32.195. That produces a lump sum present value of $127,074.
 In addition, I consider this to be an appropriate situation to adjust that figure to reflect a contingency of a substantial increase in cost. I do that on the basis that the numbers that have been used to calculate the cost of the Botox treatment are, as I understand the evidence, conservative. It is quite reasonable to expect that Ms. Picton will incur increases in those costs going forward, both with respect to the cost of the medication and the fees for injection.
 Accordingly, I will apply a positive contingency factor of 5%. The total sum to be awarded for the cost of future care is $133,427.