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Implementing Universal Pharmacare

WHEREAS Canada is the only developed country with a universal healthcare system that does
not include coverage for pharmaceuticals;

WHEREAS Canada has the highest per capita spending on pharmaceuticals among countries
with universal healthcare systems (OECD 2016);

WHEREAS single-payer Pharmacare would save Canadians an estimated $7 billion dollars per
year while improving health outcomes;

WHEREAS universal coverage of pharmaceuticals would benefit middle class Canadians
struggling to pay excessive drug costs and reduce inequality;

WHEREAS a 2015 report of the Pharmaceutical Policy Research Collaboration, University of
British Columbia (UBC), entitled “Pharmacare 2020: The future of drug coverage in Canada”
contains comprehensive policy recommendations to meet the following Pharmacare goals:

  • Access: universal access to necessary medicines
  • Fairness: fair distribution of prescribing drug costs
  • Safety: safe and appropriate prescribing
  • Value for money: maximum health benefits per dollars spent

WHEREAS in July 2017, Canada’s Premiers agreed to improve drug coverage for Canadians
and called on the federal government to collaborate on establishing a national Pharmacare
program to ensure Canadians have access to needed medications;

WHEREAS inputs from experts at Universities, healthcare professionals and stakeholders
across Canada contributed to the preparation of this resolution;

BE IT RESOLVED that the Liberal Party of Canada urge the Government of Canada to
expedite the implementation of a universal Pharmacare program based on the vision, goals and
recommendations outlined in “Pharmacare 2020” by including it in the mandate of the Minister
of Health.

 

VANCOUVER QUADRA
VANCOUVER GRANVILLE
DELTA
SENIORS LIBERALS’ COMMISSION BC
INDIGENOUS PEOPLES’ COMMISSION BC
NANAIMO– LADYSMITH
SAANICH– GULF ISLANDS
SOUTH SURREY– WHITE ROCK
WEST VANCOUVER– SUNSHINE COAST– SEA TO SKY COUNTRY
VANCOUVER CENTRE
VICTORIA
ESQUIMALT– SAANICH– SOOKE
COURTENAY– ALBERNI
WOMEN’S LIBERAL COMMISSION BC
CENTRAL OKANAGAN– SIMILKAMEEN– NICOLA

Contact: Joe Gilling
gillingjoe62@gmail.com


 

BACKGROUNDER

Implementing Universal Pharmacare

A universal national pharmacare program will not only reduce healthcare costs, with estimated to savings of $7 billion per year, but is an important visible step towards reducing the inequality between the rich and every other Canadian who struggles to pay excessive drug costs.  To quote the Prime Minister: “when governments serve special interests instead of the citizens interests who elected them – people lose faith.  Increasing inequality has made citizens distrust their governments. . . Better is always possible. But we have to make better happen.”

The World Health Organization has declared that all nations are obligated to ensure equitable access to necessary medicines through pharmaceutical policies that work in conjunction with broader systems of universal health coverage.

Canada is the only developed OECD country with a universal public healthcare plan that does not include prescription drugs:

  • Of these countries, Canada has the highest per capita expenditure on pharmaceuticals (OECD- 2016);
  • 1 in 10 Canadians report not taking drugs due to cost (Commonwealth Fund 2016);
  • 1 in 5 hospitalizations is due to prescription overuse, underuse or misuse (Dr. Steve Morgan).

Numerous researchers and health care professionals have cited the need for an equitable universal drug plan in Canada: C.D. Howe Institute, Canadian Health Coalition Canadian Doctors for Medicare, Canadian Centre for Policy Alternatives, The Canadian Federation of Nurses Union, and the Citizens’ Reference Panel on Pharmacare in Canada. Many studies and policy papers have demonstrated that a single payer pharmacare plan is estimated to save Canadians billions of dollars per year and improve health outcomes (see further reading below).

One such report, by the Pharmaceutical Policy Research Collaboration, University of British Columbia (2015), entitled “Pharmacare 2020: The future of drug coverage in Canada” contains comprehensive policy recommendations to meet the following Pharmacare goals:

  • Access: universal access to necessary medicines
  • Fairness: fair distribution of prescribing drug costs
  • Safety: safe and appropriate prescribing
  • Value for money: maximum health benefits per dollars spent

Pharmacare 2020 was a collaborative initiative of the Pharmaceutical Policy Research Collaboration, a CIHR/Health Canada Emerging Team on Equity in Access to Necessary Medicines (2009–2014). Its goal was to foster evidence-informed conversation on the future of prescription drug coverage in Canada

The report notes that “this vision of what Pharmacare is – or should be – for Canada is shared not only by the authors of this final report. The recommendations of this report have been reviewed and endorsed by over 250 university-affiliated professors and clinical experts in pharmaceutical policy, health policy, health economics, health services research, medicine, pharmacy, nursing, and psychology. Furthermore, the public opinion research by the Angus Reid Institute that is cited in this report suggests that a vast majority of Canadians share this vision too. “

The final communication from the meeting of Canada’s Premiers in July 2017 contained the following statements on the state of pharmaceutical drug coverage:

“For a number of years, provinces and territories have been pioneering work to improve the affordability, accessibility and appropriate use of prescription drugs…. discrepancies persist between the prices of prescription drugs sold in Canada and those available in certain other countries. Premiers intend to continue to work collaboratively in order to further reduce drug prices….

Premiers call on the federal government to continue to collaborate with provinces and territories on this important work and engage actively in discussions about establishing a National Pharmacare Plan to ensure Canadians have access to the medications that keep them healthy.”

In September 2016, the Standing Committee on Health requested the Parliamentary Budget Officer (PBO) prepare an estimate of the financial cost of a National Pharmacare Program.   In the report released September 28, 2017, the PBO says establishing a universal program for prescription medications would amount to about $4.2 billion in savings annually in Canada based on the list of drugs publicly covered in Quebec.  The Canadian Health Coalition said Quebec’s list of covered drugs doesn’t take advantage of the economies of scale available to the federal government, which could purchase medicine on behalf of the whole population, and that this model offers a least-case scenario of savings.

A briefing note, co-published by the CCPA and Canadian Doctors for Medicare in September 2017, indicates more than $30 billion in public and private savings will result from the implementation of a universal pharmacare system. The study outlines the savings and efficiencies under pharmacare, highlights additional benefits, and underscores the high costs, administrative complexity and poor coverage of Canada’s current patch-work of prescription drug plans.

The current Liberal Government of Canada has said it is committed to lowering the cost of medications, but has not expressed commitment to universal pharmacare.   While the Government’s mandate letter to the Minister of Health included direction to improve access to necessary prescription medications, it did not include a requirement to implement a universal Pharmacare program.

Bulk purchasing and greater expert support to encourage doctors to prescribe more accurately can cut costs significantly, as demonstrated in other OECD countries.  But reducing drug costs by even significant amounts will not make them affordable for the most vulnerable Canadians.

The government can do better- at least as well as comparable OECD countries – in providing equitable access to prescription drugs without financial or other barriers. Better is possible and can be achieved with federal government leadership.

REFERENCES

  1. Steven G Morgan… [et al], (2015) Pharmacare 2020: The future of drug coverage in Canada, and Summary of Recommendations: Moving from Principles to Policies (Vancouver (BC): University of British Columbia, Pharmaceutical Policy Research Collaboration [see www.pharmacare2020.ca ]
  2. Julie White, (2016) A National Drug Plan For All (Policy Paper) Canadian Health Coalition (CHC) [see http://healthcoalition.ca/wp-content/uploads/2017/02/Policy-Brief-NPDP.pdf]
  3. Hugh MacKenzie, (2016) Down the Drain: How Canada Has Wasted $62 Billion Health Care Dollars without Pharmacare (2016) The Canadian Federation of Nurses Union (CFNU) [see https://nursesunions.ca/wp-content/uploads/2017/05/Down_The_Drain_Pharmacare_Report_December_2017.pdf]
  4. Dr. Marc-André Gagnon, (2014) A Roadmap to a Rational Pharmacare Policy, CFNU, ISBN: 978-0-9868382-5-5 [see https://nursesunions.ca/wp-content/uploads/2017/05/Pharmacare_FINAL.pdf ]
  5. Dr. Monika Dutt, (2014) Affordable Access to Medicines: A Prescription for Canada, [see  https://www.policyalternatives.ca/affordable-access-medicines]  (Canadian Doctors for Medicare – Canadian Centre for Policy Alternatives – (CCPA) Policy Briefing Series)
  6. Dr. Marc-André Gagnon and Guillaume Hébert, (2010) The Economic Case for Universal Pharmacare, CCPA and INRS,  [see https://s3.amazonaws.com/policyalternatives.ca/sites/default/files/uploads/publications/National%20Office/2010/09/Universal_Pharmacare.pdf ]
  7. Ontario to Provide Free Prescription Drugs for Children and Youth (2017) see https://news.ontario.ca/mof/en/2017/04/ontario-to-provide-free-prescription-drugs-for-children-and-youth.html?_ga=2.114424327.1057390175.1504197360-68027293.1504197360
  8. Pharmaceutical Policy Research Collaboration. (2016) Necessary Medicines : Recommendations of the Citizens’ Reference Panel on Pharmacare in Canada,  (see https://open.library.ubc.ca/cIRcle/collections/facultyresearchandpublications/52383/items/1.0340089)
  9. Åke Blomqvist and Colin Busby, ( 2015) , Feasible Pharmacare in the Federation: A Proposal to Break the Gridlock,  C.D. Howe Institute (seehttps://cdhowe.org/public-policy-research/feasible-pharmacare-federation-proposal-break-gridlock)
  10.   Jean-Denis Fréchette , Parliamentary Budget Officer, Federal Cost of a National Pharmacare Program (2017), [see http://www.pbo-dpb.gc.ca/en/blog/news/Pharmacare]
  11. CCPA and Canadian Doctors for Medicare (2017) Cost Savings Resulting from a National Pharmacare Program [see https://www.policyalternatives.ca/publications/reports/cost-savings-resulting-national-pharmacare-program]

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