Ottawa unveils national pharmacare plan that covers diabetes, contraception to start

Health Minister Mark Hol‐ land released the longawaited details of the fed‐ eral government's pharma‐ care plan on Thursday, with a commitment to cov‐ er some diabetes treat‐ ments and contraception.

If the bill, C-64, passes Parliament, Holland will be‐ gin negotiating with the provinces and territories on a funding commitment that would cover the cost of pro‐ viding these medications to people for free.

He said he hopes people can access the program sometime this year, although a lot of uncertainties make an actual start date hard to pinpoint.

The federal government says it also will establish a fund to support Canadian di‐ abetics who need access to syringes and glucose test strips to manage their condi‐ tion but struggle to afford them.

The government says one in four Canadians with dia‐ betes - about 3.7 million peo‐ ple have the condition - have reported they're not follow‐ ing their treatment plans due to the cost.

The "first-dollar" coverage for these drugs - an insur‐ ance industry term which means the government foots the bill entirely - will help those diabetics in particular.

The pharmacare plan also will give the nine million Canadians of reproductive age better access to contra‐ ception to ensure "reproduc‐ tive autonomy, reducing the risk of unintended pregnan‐ cies and improving their abil‐ ity to plan for the future," the government said in its media release.

The exact types of contra‐ ception covered by this pro‐ gram have not yet been chosen but the government is promising that "a compre‐ hensive suite" of drugs and devices eventually will be covered in the provinces and territories that sign on.

This is the first step in what could be a much more robust regime in the years ahead, although its future is

uncertain. Some provinces are already demanding the chance to opt out of the fed‐ eral program, or are re‐ buffing Ottawa's efforts en‐ tirely.

The federal government says that, beyond diabetes treatments and contracep‐ tion, it intends eventually to implement more coverage for other medications.

Bill C-64 calls for the cre‐ ation of a national formulary - a list of essential drugs that could be eventually covered by the government - and de‐ velop a national bulk pur‐ chasing strategy.

The government says it will strike a committee of ex‐ perts to advise it on how to establish a universal, singlepayer program and will then pursue bilateral deals with each of the provinces and territories before proceeding to that sort of larger pharma‐ care plan.

The goal is 'full cover‐ age,' Holland says

The government said it wants to take a "step-bystep," incremental approach to implementing universal pharmacare, which could come with a multi-billion dol‐ lar price tag and upend the country's existing drug cover‐ age network.

Most Canadians already have coverage for prescrip‐ tion drugs through a patch‐ work of public and private in‐ surance plans. It's not imme‐ diately clear what effect a na‐ tional, universal program might have.

Holland said Ottawa will evaluate how the first phase of coverage for diabetes treatments and contracep‐ tion pans out before deciding to fund something more ex‐ tensive like a single-payer model. Canada's existing medicare program is a singlepayer system where most costs are borne by govern‐ ment.

But Holland insisted Ot‐ tawa is committed to pur‐ suing "full coverage so that everybody can afford their medication."

Holland has cited the high cost of a truly universal and single-payer pharmacare sys‐ tem as a barrier at a time when the federal govern‐ ment is trying to rein in spending after years of big pandemic-era budget deficits.

The Parliamentary Budget Officer (PBO) has pegged the cost of a single-payer pro‐ gram for all medications at nearly $40 billion a year.

Another option may be a more tailored approach that provides pharmacare cover‐ age to people who don't al‐ ready have insurance, or ex‐ panding provincial drug cov‐ erage schemes to include more people.

Cost uncertain

Federal officials speaking to reporters during a back‐ ground briefing said the gov‐ ernment does not know how much this first phase of the pharmacare program will cost taxpayers.

The final price tag for dia‐ betes treatments and contra‐ ception will be determined after negotiations with the provinces and territories, the officials said.

Pressed to provide some sort of cost estimate, Holland said the first phase will cost roughly $1.5 billion.

He said that figure could change depending on what the uptake is among the provinces and territories.

WATCH: New pharma‐ care legislation does not commit Ottawa to cover all drugs:

Holland said the funds won't be included in the up‐ coming federal budget be‐ cause the pharmacare legis‐ lation has to pass both houses of Parliament - and he still has to broker deals with his provincial counter‐ parts before the money can flow.

Some sort of national pharmacare program has been a long-time demand of pharmacists, health-care pro‐ fessionals and progressive activists who say Canada's single-payer health-care sys‐ tem should be paired with coverage for drugs and other treatments to improve popu‐ lation health.

The details were an‐ nounced after months of protracted negotiations with the NDP, which demanded the government launch phar‐ macare as a condition of the supply-and-confidence agreement that keeps the mi‐ nority Liberal government in power until 2025.

Holland said Thursday was an "important day" in Canada's history.

"Today is a giant step for‐ ward for our health system," he said.

Canadians won't have to lie awake at night worried about the cost of their dia‐ betes treatment, and women and girls will be able to con‐ trol their own bodies with free contraception, he said.

"Cost remains a barrier. Today, we're taking action to remove that barrier," Holland said.

Women and Gender Equality Minister Marci Ien called the government's plan to cover things like birth con‐ trol and the morning-after pill "a concrete step toward true and lasting gender equality."

NDP MP Don Davies, the party's health critic, negoti‐ ated with Holland for months and helped draft the phar‐ macare bill. He said this legis‐ lation is "a pathway to ensure no Canadian will be forced to suffer because they can't af‐ ford their medication."

"For the first time ever, in‐ sulin, diabetes medications and devices and contracep‐ tion will be available as a matter of right and not privi‐ lege," he said. "This is a game-changer for millions of people."

Davies promised his party won't stop advocating for the implementation of a nation‐ al, universal, single-payer program for other medica‐ tions.

NDP Leader Jagmeet Singh took credit for forcing the Liberals to act on the is‐ sue.

"If you want to see more pharmacare, you're going to need New Democrats. It's not going to be Liberals that de‐ liver more of this," Singh said.

Conservative Leader Pierre Poilievre told reporters his party will closely review what's being proposed be‐ fore taking a position.

Christina Warner, the ex‐ ecutive director of the Coun‐ cil of Canadians, an advocacy group that has long pushed for pharmacare, said the fed‐ eral government's announce‐ ment is a "major win."

"For too long, wealthy cor‐ porations have stood in the way of progress on a public pharmacare plan. But today, patients have finally pre‐ vailed. Now, the government must rapidly fund, imple‐ ment, and expand the pro‐ gram to fully meet the needs of Canadians and bring drug prices down," she said.

Canadian Life and Health Insurance Association (CLHIA), an industry group that represents major play‐ ers like Manulife and Sun Life, panned the legislation as a threat to existing private insurance.

In a media statement, Stephen Frank, the president and CEO of the CLHIA, said the government's pharma‐ care program and its planned expansion "will spend billions of dollars unnecessarily on drugs for people who already have coverage."

"It will replace what is working with a government program that will become more burdensome and ex‐ pensive over time. And it will put at risk the workplace benefit plans that 27 million Canadians count on, making life less affordable for mil‐ lions of families," Frank said.

He said private insurance plans cover twice the num‐ ber of drugs covered by even the best public plans.

Frank claimed Canadians do not want the federal gov‐ ernment "picking and choos‐ ing which drugs get covered and which don't."