Pharmacare bill is only a first step

The recent introduction of Bill C-64, An Act Respecting Pharmacare by federal Health Minister Mark Holland, is news to celebrate — coverage of diabetes medications and contraceptives could save lives and save money for millions of Canadians.

But it feels like getting an appetizer when you’re waiting for the main course. We’re hungry for more. Canadians urgently need a pharmacare plan that covers more than a handful of conditions.

As emergency physicians, we’re concerned that one in 10 people with chronic conditions sought emergency care because they could not pay for their prescriptions. More than a quarter of Canadians sacrifice food, shelter, utilities or their financial health due to drug costs.

This is no surprise when these costs have risen faster than any other part of Canadian health care and our drug prices are among the highest in the world. With the soaring cost-of-living, having coverage for prescription drugs will provide some of the relief that people and small businesses desperately need.

We were thrilled to learn that the federal government is planning to work with the provinces and territories to offer universal coverage for diabetes medications and contraceptives that will eliminate gaps based on age, income or employment.

Too often we treat patients with complications of diabetes that could have been easily avoided with access to the right medications. We appreciate how important it is for everyone to have control over their sexual and reproductive health. This announcement has enormous potential. At the same time, it’ll be hard to justify to our patients with arthritis, heart disease or seizures why they’re being left out.

A good pharmacare plan should follow the principles of our publicly funded medicare system: universal, portable, accessible, publicly administered and comprehensive. Bill C-64 gets a lot of that right, but is noticeably lacking in comprehensiveness.

Canadians need a pharmacare program that covers a broad range of health conditions and essential medications. In the ER, it would be unthinkable to tell our patients with asthma that they need to pay for their treatment — yet this will still be the case as soon as they step outside the hospital.

Bill C-64 hints at future expansion. It gives the minister 30 days to assemble a team of experts to make key recommendations. It gives the Canadian Drug Agency one year to create a list of essential medications and a cost-saving national strategy for buying drugs in bulk.

It aims to make better use of data to help patients and health professionals improve care instead of leaving it in the hands of private companies, where health information is costly or impossible to access. It strives to make drugs accessible, which goes beyond costs to key issues of fairness, stable supply, access to primary care, patient empowerment and ensuring the right drugs are used in the right way.

We’re hopeful this means that Canadians will soon have a truly universal and comprehensive pharmacare program that builds on the successes of medicare. To ensure the sustainability of our health care system, we need to treat medications as part of the package of health care, public health and social policies. But we won’t see pharmacare’s full potential without sustained political and public will to ensure it benefits everyone.

As any parent will tell you, baby steps are exciting — but they can only take you so far. A limited program will have limited benefits. Most of pharmacare’s future will be decided in the next year. Whether it stumbles or grows into a strong, sustainable and reliable program for all Canadians depends on the momentum we give it.

We must encourage our elected representatives — federal, provincial and territorial — to cover a comprehensive range of essential medications as soon as possible.