A national single-payer pharmacare program is unnecessary and will be costly for Canadian patients and taxpayers, a study says.
The Canadian Health Policy Institute (CHPI) study says there are at least four reasons why Canadians should be skeptical about pharmacare.
First, Canada’s actual experience with public drug plans strongly suggests that pharmacare will reduce access to the most innovative medicines for the 24 million Canadians who currently have employment based private drug plans, without improving benefits for the 11 million Canadians who are currently eligible for public drug plans.
Read: Universal pharmacare could save Canada billions: Study
Second, assuming realistic prices and no changes to the drug benefits currently enjoyed by Canadians, the study calculated that pharmacare will shift $13.2 billion in direct prescription drugs related costs onto taxpayers.
If implemented entirely as a centralized federal program, pharmacare would shift $25.5 billion off the provinces and the private sector onto the federal budget. In both cases, additional indirect economic costs resulting from the government take-over of the private drug insurance industry could total at least $4.1 billion in the first year.
Third, the study argues that a government monopoly is not needed to achieve universal drug insurance coverage. Under the current pluralistic public-private system, Canada already has universal drug insurance coverage for catastrophic expenses, and near universal insurance coverage for ordinary prescription drug costs.
Neither is a centralized national program needed: provincial/territorial/federal governments already have the authority to autonomously implement any kind of drug insurance system they wish within their respective jurisdictions.
Read: Provinces should provide full and universal pharmacare: Report
Fourth, the study suggests that international experience proves there are other ways to achieve universal drug insurance coverage. Several advanced countries have mandatory universal private drug insurance systems supported by means tested public subsidies.
Some aspects of Quebec’s drug insurance system are similar to these countries and Quebec has consistently provided the best access to innovative prescription drugs among all of Canada’s publicly funded drug plans.
Drug insurance reforms should focus on helping more Canadians gain the health advantages of the better coverage offered by private drug plans, says study co-author Kimberley Tran.
“We can learn a lot from mandatory universal private health insurance systems in other countries,” she adds. “In the meantime, governments should work to improve coverage for new medicines across existing public drug plans in Canada to match the patient health options provided by private drug insurance plans.”
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