The World Health Organization has recognized that access to medication is a human right. Canada is the only country in the world with a universal public health care system that doesn’t include access to prescription medication.
Canada’s current patchwork of drug coverage leaves millions of Canadians falling through the cracks. Even those who have drug plans still often end up having to pay costly deductibles and copayments.
As a result, many Canadians are having to choose between putting food on the table and buying the medication they need. Currently, 1 in 4 households can’t afford their medications. This leads to people getting sicker and having to visit the doctor and the hospital more often. This takes up limited resources in our health care system.
Canada pays the third highest prices in the world for prescription medications. Spending on medication is continuing to rise. We currently spend more on medications than we do on doctors.
To ensure that everyone in Canada can access the medications they need, we need a national pharmacare program. This program must be public, universal, comprehensive, accessible and portable. Research has shown this could save the government as much as $11 billion per year.
The issue in detail
About 70% of Canadians rely on private insurance plans provided through their employers. There are over 100 000 private drug plans across the country. They all provide different levels of coverage. Workers often pay for their drug coverage in the form of lower wages. If people lose their jobs, change jobs or retire, they often lose their drug coverage.
Over 20% of the population relies on public drug plans. There are over 100 provincial, territorial and federal drug plans across the country, and they all provide different levels of coverage. Most public drug plans cover certain populations such as seniors or people on social assistance. The provinces and territories all cover different medications, which leaves access to some medications dependent on where you live. For example, the same cancer medication costs $0 in Nunavut, $3,000 in BC and $20,000 in PEI.
Having a drug plan doesn’t mean that you are adequately covered. Both private and public drug plans often have high deductibles and co-payments. Drug plans also often limit the amount that people can claim per month or per year. These out-of-pocket expenses can make medications unaffordable.
Among OECD countries, Canada pays some of the very highest prices for prescription medications. We could significantly lower these prices through bulk buying. By negotiating drug prices for the country as a whole, we’d have much better bargaining power.
Public, universal pharmacare could save over $11 billion per year. Employers would benefit by not having to cover employees’ drug plans. Households would benefit by not having to pay out-of-pocket for medications. Pharmacare would be good for people’s health and good for business. It would save money and save lives.
Big Pharma and the insurance industry have been lobbying the government to adopt a “fill the gaps” approach to pharmacare. This would maintain the thousands of drug plans that are currently in place and simply add insurance for those who lack coverage. However, it wouldn’t ensure that everyone has adequate coverage and it wouldn’t enable big price reductions through bulk buying. Only public, universal pharmacare would do this.
Like other health care services, access to medication should be based on need, not on people’s ability to pay. Canada needs universal, public pharmacare now.
- September 2017: The Office of the Parliamentary Budget Officer released a report showing that a universal, public pharmacare program could save Canadians $4.2 billion, based on conservative estimates.
- February 2018: As part of Budget 2018, the federal government appointed an Advisory Council on the Implementation of National Pharmacare chaired by Dr. Eric Hoskins. The Council will report to the federal Minister of Health and the Minister of Finance with recommendations on options for implementing pharmacare.
- April 2018: The Standing Committee on Health presented a report to the House of Commons recommending that Canada adopt a universal, public pharmacare program. The Committee concluded that pharmacare should be universal and publicly-funded since merely addressing gaps in existing drug coverage will not lead to better health outcomes or better cost control.
- March 2019: As part of Budget 2019, the federal government proposed to provide Health Canada with $35 million over four years to establish a Canadian Drug Agency Transition Office. The new drug agency would be responsible for assessing the effectiveness of new medications, negotiating the prices of medications, and recommending medications to include on a national formulary.
- March 2019: The Advisory Council on the Implementation of National Pharmacare is expected to release its final report with additional recommendations in June 2019. It has released an Interim Report in which it identified several core principles and recommended three foundational elements for pharmacare:
- Creating a national drug agency to develop and manage a national drug formulary (a list of medications that are covered by public insurance), to negotiate the prices of medications and to monitor the safety and effectiveness of medications
- Developing a comprehensive, evidence-based national formulary
- Investing in drug data and information technology (IT) systems.
The CHC is calling for:
- A public, universal pharmacare program that covers medication in the same way as doctors and hospitals.
- Get informed by reading the Pharmacare Consensus Principles.
- Take part in the Canadian Labour Congress’ campaign for universal, public pharmacare.
- Watch videos from our 2017 policy conference on a National Public Drug Plan.
Pharmacare Consensus Principles (2018)
Why Canada needs universal public pharmacare (Canadian Health Coalition, 2019)
The economic benefits of universal public pharmacare (Canadian Health Coalition, 2019)
Mythbuster: A National Public Drug Plan (Canadian Health Coalition, 2017)
Policy and Research Documents
The Economic Case for Universal, Public Pharmacare (Keith Newman for Canadian Health Coalition, 2019)
CHC Submission to the Advisory Council on the Implementation of National Pharmacare (Canadian Health Coalition, 2018)
Videos from the CHC policy conference “A Prescription for Equity” (Canadian Health Coalition, 2017)
CHC Policy Brief: A National Drug Plan For All (Canadian Health Coalition, 2016)
Down the Drain: How Canada Has Wasted $62 Billion Health Care Dollars without Pharmacare (Hugh MacKenzie for CFNU, 2016)
A Roadmap to a Rational Pharmacare Policy (Dr. Marc-André Gagnon for CFNU, 2014)
The Economic Case for Universal Pharmacare (Dr. Marc-André Gagnon and Guillaume Hébert for CCPA and INRS, 2010)
Life Before Pharmacare (CHC and CCPA, 2008)