National pharmacare program should be voluntary for provinces, territories: premiers

In a meeting in Saint Andrews, N.B., on Friday, provincial and territorial premiers met to discuss ways to improve health care for Canadians, including the implementation of a national pharmacare program.

Linda Silas, president of the Canadian Federation of Nurses Unions, was also in the meeting and said she is encouraged that there is support from the provinces after they came out last year in favour of a national plan. “They are all in support of reforming our system, they see it in their budgets,” she said. ”They want to know who is going to pay for the transformation because there will be initial costs, and also how will the pie be divided after that.”

Eric Hoskins, who quit his cabinet post in February to chair the advisory council on the implementation of national pharmacare, told The Canadian Press the council is carrying out consultations across the country. He said consensus will have to be built, but he expressed optimism that something can be done, pointing out that estimates suggest 10 per cent of Canadians are unable to afford their drugs.

Read: Feds encouraging Canadians to weigh in on national pharmacare

“We are not yet at the stage where we’ve established what the best cost-sharing mechanism might be, let alone the model itself,” he cautioned.

Hoskins said there are more than 100 different public plans across the country and in excess of 500,000 private plans. ”We pay between 30 and 40 per cent higher than the other similar industrialized countries pay for their medications,” he said. “Part of the reason is that we have such a diverse number of purchasers.”

The parliamentary budget office pegs the total cost of pharmacare at about $20 billion and says about $4 billion in cost savings can be realized with a national plan. ”The parliamentary budget office has indicated that we could spend considerably less if we were to make certain changes and find efficiencies for example in bulk purchasing and other areas,” said Hoskins.

Discussing the potential benefits and challenges of a national pharmacare program, the premiers emphasized that a successful program requires adequate and sustained federal funding. 

Read: Commons committee recommends national pharmacare program

A press release noted further discussions with the federal government on pharmacare will be governed by the following principles:

  • Improving access through removing cost barriers for patients should be the focus;
  • Development should be based on the best available evidence about potential benefits, risks, costs and reliability of supply;
  • Provinces and territories must retain responsibility for the design and delivery of public drug coverage; and
  • Federal pharmacare funding must be long-term, adequate, secure, flexible and take into consideration present and future cost pressures.

At the meeting, premiers reiterated their support for the principle of asymmetrical federalism and that any jurisdiction that wishes to maintain full control over drug insurance should have the right to opt out unconditionally, with full financial compensation, should the federal government participate financially in the establishment of a pharmacare plan. Quebec has already indicated its intention to follow that path and all provinces and territories reserve the right to do the same, noted the release.

Read: Should employers share potential tax burden for pharmacare?