Canadian Universal Drug Program

Canada is the only country in the world that has a publicly funded, universal health care system that doesn’t include a national plan to cover prescriptions. We are among the highest spenders for medications in the OECD.

Prescription drug coverage in Canada differs widely depending on where you live, your health status, your income, and your age. Right now, each province has its own Pharmacare program, there is no consistency and costs vary.

A universal prescription drug plan could not only reduce total spending, it would also cover everyone at an affordable price.

Other countries such as New Zealand negotiate brand name drug prices that are about 40% lower, and generic drug prices that are 90% lower than Canadian prices because they buy medications in bulk as a country, negotiating pricing and ensuring stable supplies.

A growing number of advocates (including CARP) would like to see a national drug program soon become a reality.

Prescriptions have become unaffordable for some

In a new study, the Canadian Federation of Nurses Unions (CFNA) estimates that around 1,000 Canadians die prematurely of such ailments as heart disease and diabetes every year because they can’t afford their medications as prescribed.

They are splitting their pills, cutting back on prescriptions, and many even stop taking them entirely because of the cost.  They are making a choice between paying for the medications they need and paying for other basic necessities like food and utilities.

This ends up costing the health care system in the long run.

So, what’s the delay?

A national Pharmacare program is an idea that has been kicking around for decades.  It was originally recommended in 1964 – two years before the national Medical Care Act was adopted. It was brought up again in the 2002 Romanow Commission on how to modernize health coverage.

Last spring, the House of Commons’ standing committee on health added another report to the growing pile.  The policy goals are:

  1. Access: Universal access to necessary medicines.
  2. Fairness: Fair distribution for prescription drug costs.
  3. Safety: Safe and appropriate prescribing.
  4. Value for money: Maximum health benefits for dollars spent.

The main arguments against a universal drug program are the potential costs, access to new drug therapies and the impact on the private drug benefits industry.

But, according to the Canadian Medical Association, the total cost of a national Pharmacare program would actually be less than what is currently being spent by public and private drug plans and patient payments combined.

An election promise

One of the election promises by the Trudeau government in 2015 was an affordable prescription drug program.  A special advisory council has now been formed to study how to execute the plan and the recommendations are expected to be available by March or April of 2019 and implemented just in time for the next election.

Patent protection under USMCA

One result of the recent USMCA trade agreement is the extension of patent protection for US Pharmaceutical companies on their biologic medicines.  They will now have at least 10 years exclusivity before allowing generic competition from Canadian companies to lower costs.

Biologics are used to treat a large range of debilitating conditions including many cancers, rheumatoid arthritis, Crohn’s disease and multiple sclerosis.

They are the fastest growing segment of health care spending and are among the costliest treatments, consuming 22% of public drug plans.

This agreement becomes a challenge to the implementation of an affordable national Pharmacare plan.

The Bottom Line

Access to affordable prescription medicines is a high priority for Canadians.

Canada currently has one of the most expensive systems for purchasing prescription drugs in the world.

While the pan-Canadian Pharmaceutical Alliance negotiates reduced drug prices on behalf of the provinces, only generic discounts are accessible.

A better deal could be made with a bulk purchasing system for the entire market.  It would mean leveraging our buying power to help contain drug costs, guarantee stable supplies, and ensure all Canadians have access to prescription drugs to improve the future health outcome of our population.



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