Surrey Business News

A Uni­ver­sal Phar­ma­care Pro­gram is Good for Cana­dian Busi­nesses and Our Econ­omy

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The Sur­rey Board of Trade wants the fed­eral gov­ern­ment to adopt a Uni­ver­sal Phar­ma­care Pro­gram.

The Sur­rey Board of Trade’s po­si­tion pa­per, re­leased in 2015, in­di­cates that drug cov­er­age in Canada is pro­vided through an incomplete patch­work of pri­vate and pub­lic pro­grams that varies across prov­inces.

This frag­mented sys­tem re­duces ac­cess to medicines, di­min­ishes drug pur­chas­ing power, du­pli­cates ad­min­is­tra­tive costs, and iso­lates phar­ma­ceu­ti­cal man­age­ment from the man­age­ment of med­i­cal and hos­pi­tal care. It is need­lessly cost­ing Cana­dian busi­nesses bil­lions of dol­lars every year.

The fed­eral gov­ern­ment, in this year’s fed­eral bud­get is ex­pected to an­nounce a fill-in-the­gaps in­sur­ance model. This will con­tinue the frag­men­ta­tion, leav­ing work­ers who need spe­cial­ized in­sur­ance needs out of the work­force with­out a struc­tured ap­proach to Phar­ma­care.

The Sur­rey Board of Trade, as the only cham­ber of com­merce/board of trade to speak at the Fed­eral Stand­ing Com­mit­tee on Health in May 2016, in­di­cated that:

• Man­ag­ing health­care in dis­crete si­los, whereby doc­tors man­age care, and in­sur­ance com­pa­nies man­age the phar­ma­ceu­ti­cals re­quired, is greatly in­ef­fi­cient. Health care providers should be the first and fi­nal man­agers of all health

care needs;

• Re­mov­ing phar­ma­ceu­ti­cals from in­sur­ance cov­er­age al­lows for ex­pand­ing other, non-ur­gent ser­vices, such as hear­ing aids, den­tal care, and men­tal health sup­port – as well as sup­port­ing health pre­ven­tion pro­grams for busi­nesses and in­dus­tries;

• Small busi­nesses — a cor­ner­stone of our econ­omy — are the least likely to of­fer drug cov­er­age. Sim­ply put, they can’t af­ford it for the same rea­son that in­di­vid­u­als find it dif­fi­cult or im­pos­si­ble to get in­sur­ance if they have chronic dis­ease: pri­vate in­sur­ance com­pa­nies are not char­i­ties. Pri­vate in­sur­ers must charge groups and in­di­vid­u­als pre­mi­ums that re­flect their ac­tu­ar­ial risk;

• The prob­lem is that about one in 10 adults have costly, chronic needs for pre­scrip­tions — to treat such con­di­tions as asthma, di­a­betes, hy­per­ten­sion, heart­burn or arthri­tis. Smaller firms have dif­fi­culty shoul­der­ing the risk of em­ploy­ing a worker with such needs, or one with a spouse or child with such needs. The sit­u­a­tion is worse for en­trepreneur­s who want to work for them­selves but have chronic health needs in their fam­i­lies;

• All of this this leads to a labour mar­ket wherein peo­ple with chronic med­i­cal needs in their fam­i­lies must choose jobs based on in­sur­ance. In the face of a skill short­age cri­sis in many in­dus­try sec­tors, this de­ci­sion-mak­ing process does not work;

• Mat­ters will only get worse as more spe­cial­ized medicines — which can cost $50,000 or even $500,000 per pa­tient per year — come to mar­ket. Cur­rently, spe­cialty medicines ac­count for 1.3 per cent of pri­vate drug-plan claims, but their costs add up to a stag­ger­ing 24.2 per cent of to­tal drug-plan spend­ing. These ex­tra­or­di­nary costs should not be borne by a sin­gle busi­ness;

• Drug prices in Canada are among the high­est in the world, mostly be­cause our myr­iad of pri­vate drug plans di­lutes the coun­try’s po­ten­tial pur­chas­ing power on the world mar­ket for phar­ma­ceu­ti­cals;

• A Uni­ver­sal Phar­ma­care Pro­gram would save Canada’s pri­vate sec­tor more than $8 bil­lion an­nu­ally while cov­er­ing all Canadians for vir­tu­ally all drugs — in­clud­ing all ex­pen­sive bi­o­logic drugs;

• Our es­ti­mates in­cluded the cost of in­creased use of medicines that will re­sult from in­creased ac­cess for Canadians who are cur­rently un­der- or unin­sured. Ad­di­tional sav­ings can im­prove pa­tient health and re­duce de­mand on our hos­pi­tals;

• Of par­tic­u­lar in­ter­est to Cana­dian busi­nesses is the fact that, if a na­tional phar­ma­care pro­gram on par with av­er­age com­pa­ra­ble coun­tries were in­sti­tuted to­day, pri­vate-sec­tor em­ploy­ers and unions would save more than $5.5 bil­lion, net of the $2 to $10 co-pay­ments that would be charged un­der such a pro­gram;

• It is im­por­tant to note that such sav­ings would not come at the ex­pense of the tax­payer. The power of a uni­ver­sal pub­lic pro­gram as a ne­go­tia­tor of drug prices and pro­moter of ap­pro­pri­ate pre­scrib­ing is such that the in­cre­men­tal pub­lic cost to gov­ern­ment of a uni­ver­sal pro­gram — in­clud­ing the cost of in­creased use of medicines re­sult­ing from ex­panded pub­lic cov­er­age — would be only $1 bil­lion, shared across all 13 prov­inces and ter­ri­to­ries and the fed­eral gov­ern­ment;

• Uni­ver­sal Phar­ma­care would not only help the work­ing poor, the unin­sured and the sick. It would also en­able Cana­dian busi­nesses to re­main com­pet­i­tive in the global mar­ket­place by se­cur­ing the health of their work­force at far lower cost to busi­ness and so­ci­ety as a whole.

The lack of uni­ver­sal Phar­ma­care is bad for Cana­dian busi­nesses, large and small.

It is time for Canada’s busi­ness lead­ers to call for uni­ver­sal, pub­lic Phar­ma­care. Busi­nesses care about the health and well-be­ing of the Cana­dian work­force. Em­ploy­ees that can af­ford the medicines as and when pre­scribed will be health­ier, hap­pier and more pro­duc­tive.

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