Recently, the future of Canada’s would-be national pharmacare system grew murky. Health Minister Marjorie Michel has indicated that the government is at least not ready to go all-in on adopting every one of the expert committee’s recommendations. The committee posted its report to the public last Friday. It sets a concrete plan for the federal government to work with provinces and territories to ensure coverage for basic medications, including contraceptives and diabetes medications.
Last autumn, the last minority Liberal government adopted the Pharmacare Act. This was the impetus for creating the 2019 expert committee on pharmacare. This act requires the federal government to negotiate with the provincial governments so that all Canadians can have access to the medicines they need. Dr. Eric Hoskins, who authored a 2019 report on pharmacare for the prior administration, emphasized that the latest findings provide a “very clear path toward implementing pharmacare.”
According to the committee’s report, the estimated cost of maintaining an essential medicines list is projected to be between $6 and $10 billion annually. Dr. Navindra Persaud, the committee’s chair, foresees a major fiscal hit on the federal government coffers. He estimates the new burden at up to $3 billion per year. The report calls on the federal government to develop a national formulary of core medications. It further calls for proper funding so that all Canadians can receive these prescriptions free of charge with their provincial health cards.
In a significant recommendation, the committee urged the federal government to offer sustainable funding to all provinces and territories to fully cover the costs associated with drugs on the essential medicines list. Additionally, it recommended that private insurers fill gaps with complementary coverage to improve access.
The last federal government promised $1.5 billion over five years to roll out the pharmacare program. More than 60 percent of this money is already committed to four deals they’ve already signed. This begs the question of whether the program could realistically be expanded without more money.
Minister Michel acknowledged that her government is currently reviewing the recommendations received from the expert committee earlier last month. She stopped short of pledging to deliver a specific implementation timeline or framework.
“As you know, we have a lot of independent expert panels and they have their views, but it is non-binding for the government,” – Marjorie Michel
Dr. Linda Silas, president of the Canadian Federation of Nurses and one of the expert committee members, shared her anger at seeing no movement towards universal pharmacare. She highlighted that the report provides actionable next steps in the form of eight visible recommendations. These provide a straightforward route to creating a national program, and unlike bilateral agreements, they don’t need new legislation.
“The eight recommendations are clear. The minister and government could start a national pharmacare program today if they wanted, without any new legislation, without any new bilaterals,” – Linda Silas
She added that motivating politicians to make the hard decisions is key to getting things moving.
“I think we’re going to have to go there. We’re going have to convince, again, a politician to say, ‘You have all the work, you have frameworks, you just need to bite the bullet and do it,’” – Linda Silas
Dr. Hoskins weighed in on the ongoing discussions, noting that previous Liberal governments demonstrated a commitment to advancing pharmacare.
“(Liberal governments) showed the political will to bring it this far, so I’m hoping that they can show additional resolve and courage to take it to the next step,” – Dr. Eric Hoskins
