Panel calls for universal system
OTTAWA — A Canadian advisory council studying prescription drug coverage said on Wednesday the federal government should create a universal, single-payer public pharmacare system, and warned that the current framework requires significant reforms.
The seven-person advisory council, headed by former Liberal Ontario Health Minister Eric Hoskins, said the full single-payer system should be implemented no later than Jan. 1, 2027. The council said a national drug agency should be created first, with coverage for essential medicines in place by Jan. 1, 2022.
Canada is the only country with a universal health care system that does not include universal coverage for prescription drugs. Most prescriptions are paid for through employer-funded drug plans, while some are covered by government programs for the elderly, or people with low incomes or very high costs.
“There are too many people in our country who die prematurely or suffer needlessly in ill health because cost is a barrier to accessing prescription drugs,” Hoskins wrote in his report. He added that both public and private drug providers told the council the system is “near the breaking point and in need of significant, even transformational reforms.”
The council estimated the national pharmacare would cost an additional C$3.5 billion ($2.6 billion) at its launch in 2022. As more drugs are added, the advisory panel estimated the annual incremental costs would reach C$15.3 billion in 2027.
Drug prices in Canada are among the highest in the world, with Canadians spending C$34 billion on prescription medicines in 2018. Government surveys show some 20% of Canadians are uninsured or underinsured.
The current patchwork system is made up of more than 1,000 public and 100,000 private plans a system that can make it difficult for smaller payers to negotiate for lower prices.
Canadian Prime Minister Justin Trudeau’s Liberal government has promised to create some kind of national pharmacare program, with details of its approach potentially a key issue in the country’s October federal election.
Canada, like many governments around the world, is grappling with the rising cost of prescription drugs, particularly expensive new specialty treatments for cancer and rare diseases.
In its most recent budget the Trudeau government promised modest changes, including a new national drug agency to negotiate prices and new funds for drugs that treat rare diseases.