Industry responds to expert panel’s pharmacare report

Industry groups had mixed feelings about an expert panel’s report calling for a single-payer pharmacare plan.

Released on Wednesday by Eric Hoskins, former Ontario health minister, the report recommended Canada and the provinces work together to create a unified program that addresses the country’s patchwork of prescription drug plans. Provinces and territories, the panel said, should deliver the program in a manner that “meets or exceeds” the agreed-upon standards in exchange for federal funding.

The advisory council recommended creating a new drug agency that would develop a national formulary, starting with common or so-called essential medicines by Jan. 1, 2022, and expanding to a fully comprehensive formulary by Jan. 1, 2027.

Read: Expert panel calling for single-payer pharmacare plan

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

In a press release, the Canadian Life and Health Insurance Association said it supported some of the recommendations listed in the report, including the creation of a drug agency, which would negotiate better drug prices for Canadians, and earmarking funds to improve access to high-cost drugs for rare diseases, both of which were announced in the 2019 federal budget in March.

Stephen Frank, the CLHIA’s president and chief executive officer, said the association also wanted to see a minimum standard list of drugs that both public and private plans should meet “so there is more consistency across Canada and that existing gaps in coverage are closed.”

Read: Budget 2019: Feds to develop a strategy for high-cost drugs for rare diseases

However, the CLHIA noted, more than 25 million Canadians have access to prescription medications through their workplace benefits plans, which “provide thousands of pharmaceuticals that even the most generous public plans do not provide.”

The association estimated 7.7 million Canadians could risk losing access to drugs if their workplace plans were replaced by “even the most comprehensive government-run public plan.”

“We believe there is an achievable and affordable path forward that ensures all Canadians are able to access the medications they need without putting at risk what’s working today,” said Frank.

The report recommended that Canadians should still be able to purchase private insurance to supplement national pharmacare coverage.

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

Innovative Medicines Canada said it believes the panel’s recommendations could improve access to medications for the Canadians who don’t have private insurance and haven’t enrolled in a public plan.

“Our industry supports universal pharmacare to make prescription drugs more affordable and more accessible to all Canadians,” said Pamela Fralick, president of IMC, in a press release. “Regardless of the model the government ultimately adopts, it must ensure Canadians maintain access to at least the same range of cutting-edge medicines they rely on today to survive and maintain their quality of life.”

IMC noted it believes private plans should continue to exist alongside pharmacare to make sure patients don’t experience disruption in their care if their medications aren’t listed on the national formulary.

Read: Health Canada moving to simplify generic drug approval process

In particular, the Canadian Generic Pharmaceutical Association is supporting the panel’s call to implement mandatory generic substitution policies to keep the pharmacare program affordable. It estimated

affordable. It estimated every one per cent increase in the use of generic medicines saves Canadians $586 million.

“Strategies such as charging lower copayments for generic equivalents and addressing the negative impact of brand-name coupon cards are also important initiatives, and [the] CGPA is pleased that the council has stated its support for these measures,” said Jim Keon, the association’s president, in a press release.

Read: Big pharma may cut R&D, delay new drugs if pharmacare means more generics: memo