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Column: From the Hill -- Canada needs Pharmacare

When Canadians are asked what makes them proud to be Canadians, many say that our health care system is a big part of that pride.  We care about each other and want to make sure that everyone has access to health care when they are sick or injured.  But our medicare system has some big gaps, and one of those is our access to prescription drugs.

On March 6th the Advisory Council on the Implementation of National Pharmacare released an interim report on the need for a national program to provide prescription drugs to Canadians.  Unfortunately, in Tuesday’s budget, the Liberal government did essentially nothing to advance this program.

When we are sick, we can go to a doctor for free.  But if that doctor prescribes needed medicines, we usually have to pay for those medicines ourselves, and some of them can be very expensive.  Some of us are fortunate to have extended medical benefits that cover the cost of most drugs, but nearly 20 percent of Canadians report they or someone in their household has not taken their prescribed medicines in the last year due to high costs.

When people don’t take their medicine, they often get sicker and some end up in hospital, adding significant costs to our health care system.

On top of this, Canadians pay more for drugs than almost any country in the world.  Commonly prescribed drugs such as statins cost ten times as much here as they do in New Zealand, for instance.  Prescription drug spending in Canada has grown dramatically over the past few decades, increasing from $2.6 billion in 1985 to $34 billion in 2018, and are anticipated to grow to more than $50 billion by 2028.

Drug spending is now the second largest category of spending in Canadian health care, surpassing spending on physician services – only hospitals cost more.

What could solve all these problems, and save us billions of dollars in doing so, is a universal public pharmacare program.

While the Advisory Council’s report doesn’t set out detailed plans for a universal pharmacare program, it recommends these core principles:

  • ensure that all Canadian residents have access to prescription drugs based on medical need, without financial or other barriers to access;
  • ensure that coverage is portable and consistent across all jurisdictions;
  • provide access to a comprehensive, evidence-based formulary, with special consideration for drugs for rare diseases;
  • be designed and delivered in partnership with patients and citizens;
  • be founded on strong partnership between federal, provincial and territorial governments and Indigenous peoples; and,
  • include a robust pharmaceutical management system that promotes safety, innovation, value-for-money and the sustainability of prescription drug costs.

Many Canadians have access to some form of prescription drug coverage through Canada’s patchwork of more than 100 public and 100,000 private insurance plans. However, patient eligibility and the depth of coverage varies dramatically.  These inconsistencies particularly affect vulnerable populations, such as low-income individuals in precarious working arrangements, and seniors.

Under universal pharmacare, the federal government becomes the purchaser of prescription medications on behalf of all Canadians. By using the purchasing power of a single payer, we can take advantage of lower prices for drugs—the way New Zealand and many other countries do.

Under pressure from big insurance and pharmaceutical corporations, the Liberal government has hinted that the best way forward is a ‘fill-in-the-gaps’ strategy to help Canadians without existing coverage—even though this will likely cost more than our current system and would add to the complicated patchwork mess of multiple drug plans.

The time for half measures and further study is over. What is needed is a universal, public pharmacare program that will save billions of dollars and provide everyone with the essential prescription medications they need.