National pharmacare in Canada should include the creation of a national drug agency with a comprehensive, evidence-based formulary, according to an interim report.
But Canadians will have to stay tuned for details on what exactly a national pharmacare system might look like – a final report with specific recommendations is expected later this spring.
The current system for prescription drugs is “inadequate, unsustainable and leaves too many Canadians behind,” said Dr. Eric Hoskins, chair of the Advisory Council on the Implementation of National Pharmacare, which prepared the report.
According to that report, in the council’s consultations with Canadians, health care providers, governments and other interested groups, “Very few people advocated for the status quo.”
The council identified three major challenges facing Canada with regard to prescription drug coverage. First, as many as one in five Canadians have trouble paying for prescription drugs, according to the report.
“Canadians should not have to choose between paying for medications and putting food on the table,” said health minister Ginette Petitpas-Taylor, at an announcement on Wednesday.
The advisory council also found that drug coverage varies considerably across the country, as well as depending on people’s age, employer and medical condition. “The Council heard from families with seriously ill children who moved across Canada solely to benefit from another province’s more generous public drug plan,” reads the report.
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Finally, the report notes that the cost of pharmacare has ballooned over several decades, increasing from $2.6 billion in 1985 to $34 billion in 2018.
“When we look at the costs of the system, it’s staggering,” said finance minister Bill Morneau.
To solve these problems, the interim report lays out three “building blocks” to guide the government’s approach to pharmacare.
A national drug agency will oversee the pharmacare program and take on work like negotiating with drug manufacturers on prices and evaluating the clinical evidence and value-for-money of different medications.
It would use this information to create a national drug formulary – a list of medications available to all Canadians. This formulary would harmonize drug coverage across Canada, according to the report.
The report also recommends creating a data system to keep track of drugs, which according to Hoskins, “would cover the entire spectrum of care from the doctor’s office to the pharmacy.”
WATCH: Pharmacare advisory council recommends national drug agency formulary
Hoskins said that the council has not yet decided what exactly the pharmacare system will look like — such as whether it will maintain a combined public-private coverage system and how it will work. “I know everybody is anxious to see the final report. I’m anxious to get it done as well.”
Longtime pharmacare advocate Linda Silas called the interim report “promising.” Silas, who is president of the Canadian Federation of Nurses Unions, said she was particularly pleased by the inclusion of an evidence-based national drug formulary.
Canadians pay too much for drugs under the current system, she said. “We know the evidence. It’s all because we have over 100,000 private plans, over 100 public plans, and for such a small country.”
A single buyer could save money by buying in bulk, she thinks. “We’re what, 37 million now? So you’re buying for 37 million, you’re not buying for the 8 million in Quebec or the less than a million in the province of New Brunswick.”
Silas was also happy to see that the “core principles” of the yet-to-be-announced pharmacare program include mentions of drug coverage for all Canadians that is portable and consistent across all jurisdictions.
She’s still waiting on details though.
“What they haven’t come up with in this report is, how are we going to pay for this?”
While he commended the way the report described how the current drug system is “failing Canadians,” NDP health critic Don Davies said that the Liberals missed an opportunity to commit to “real change in drug coverage.”
“Today’s report leaves the door open to a private, U.S.-style patchwork system of coverage, and it fails to recommend the system that delivers the best results for patients: a public, single-payer delivery model,” he said in a statement.
Hoskins expects the final report to be released “later this spring,” meaning anytime between March and June.
There may be some hints in the upcoming federal budget though, to be released March 19. Petitpas-Taylor said Wednesday that the government plans to move forward with modernizing drug pricing rules.
According to Morneau, while he wasn’t “going to announce the budget here this morning,” the government will “take a look at this informed by the interim report that the council has provided to us.”
Silas said that until Canada actually has pharmacare, she will continue to push for it. “We want to be invited to the national pharmacare party but it’s only when it’s going to be passed in legislation that we will be really celebrating.”
“We as Canadians in 2019 can change the legacy of our health care system for generations to come.”
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