Expert panel calling for single-payer pharmacare plan

An expert panel is calling for the federal government to work with the provinces and territories to create a single-payer public pharmacare program.

Eric Hoskins, Ontario’s former health minister, released the findings in Ottawa on Wednesday, noting the recommendations aim to address the country’s patchwork of private and public prescription drug plans. The council is recommending a new drug agency that would be responsible for developing a national formulary, beginning with common or so-called essential medicines by Jan. 1, 2022. It also recommends that the initial formulary is expanded to a “fully comprehensive formulary” no later than Jan. 1, 2027.

Read: Expert panel on pharmacare suggests harmonized national drug formulary

The report suggests the federal government work with the provincial and territorial governments to begin to implement the national pharmacare program as soon as possible, with a new financing agreement to be developed jointly by governments and with Ottawa paying the incremental costs.

It also recommends that out-of-pocket costs for all products listed on the national formulary not exceed $5 per prescription, with a copayment of $2 for essential medicines and an annual maximum of $100 per household per year.

The 2019 Sanofi Canada health-care survey, which was launched on Tuesday, found many Canadian benefits plan sponsors (22 per cent) and plan members (42 per cent) are unaware about the possibility of a national pharmacare program.

Plan members were most likely to say their level of knowledge was low (35 per cent) and 40 per cent of plan sponsors described their knowledge level as medium. However, 71 per cent of plan members said they’d like to understand more about national pharmacare and its possible implication on workplace health benefits plans — increasing to 80 per cent among those in poor health and 80 per cent among those with drug plan maximums.

Read: A primer on the parliamentary report on pharmacare and its impact on the benefits industry

“That’s really encouraging as we move towards the [federal] election and to see if that might actually impact some voting,” said Barb Martinez, practice leader for benefits solutions, group benefits at the Great-West Life Assurance Co. and one of the survey’s advisory board members, during the launch event in Toronto on Tuesday.

More than half (59 per cent) of plan sponsors said they’re concerned about the potential impact national pharmacare would have on their workplace benefits plans. When asked to consider four different scenarios for a national program, both plan sponsors and members supported two options that didn’t affect the workplace drug plan or that helped the workplace plan in certain situations. Plan sponsors were relatively supportive of the two options that would reduce or eradicate coverage by private drug plans, while plan members were less supportive of these options.

Read: What are the implications of pharmacare reform for private drug plans?

“There is a value proposition around holistically supporting health, and that’s more easily achieved when we keep all benefit lines together,” said Christine Potvin, vice-president of group life and disability at Sun Life Financial and a member of the advisory board. “If the government manages drug coverage exclusively, we may lose the opportunity to fully leverage data to illustrate the gaps and proactively respond to trends in chronic disease with early, personalized interventions.”