Discussion around implementing a national universal pharmacare strategy is growing louder ahead of next month’s federal election.
In its 2019 budget, the federal government said it would work with partners to move forward on a national pharmacare program, including the creation of a new national drug agency and formulary, as well as a national strategy for high-cost drugs for rare diseases.
While these measures were further discussed in the government’s 2020 fall economic statement, a universal national pharmacare program wasn’t included in the 2021 federal budget. Instead, the government reiterated it would proceed with funding the previously announced high-cost drug program and would directly engage with willing partners on pharmacare.
Ezaque Lopes, national head of practices at Arthur J. Gallagher & Co., says the proposed high-cost drug strategy could be especially helpful to plan sponsors. “Over the last several years, we’ve seen [the development of] lots of high-cost drugs that are really helping plan members, but that pipeline is growing and there’s more drugs coming to the marketplace that are very expensive. . . . If we can ensure that level of support exists, it would help employers carry on with the programs they offer today while ensuring that employees who have been inflicted with some of these terrible diseases get access to that coverage.”
However, if all lines of medication currently offered by private plans were covered by pharmacare, accessibility to prescriptions — as well as the value offered to plan members — could be hindered, says Lopes. “Carriers have done a very good job of ensuring there’s expedited access [to medication]. Introducing a national pharmacare program could get in the way of that easy access, such as through an approval process.
“[With a benefits plan] there’s also the ability to integrate drug and disability coverage, so it becomes an indicator of future disability. [Plan sponsors] are getting access to information they wouldn’t necessarily get if [drugs were] funded and paid for by the federal government.”
However, Dave Patriarche, founder of Mainstay Insurance Brokerage Inc., says a national pharmacare program funded by general tax revenue could benefit employers by reducing volatility in plan rates and producing additional savings.
“The biggest volatility is in drugs. If you took the drug part of the plans and gave it to the government, it could make life a whole lot easier for employers. . . . The problem is funding — it can’t just be a tax on employers. If they’re taking away group benefits that are privately run and make them government run but charge the employers, that’s far from ideal.”
Benefits Canada reached out to Innovative Medicines Canada, which represents the pharmaceutical industry, but it declined to comment ahead of an election.