Call for national prescription drug plan gathering wide support
OTTAWA — It’s a buzzword in the medical community, although one that hasn’t quite caught fire yet with Canadians at large: Pharmacare, a national program that would see prescription drugs covered through a publicly funded system rather than out of pocket.
Many doctors are clamouring for it. Canadians dream of it when faced with sky-high drug costs as they fight cancer, diabetes, heart disease and other illnesses.
Even private insurers aren’t entirely opposed.
And now politicians are starting to take up the cause. The federal NDP is calling for national Pharmacare, while Eric Hoskins, Ontario’s new health minister, has emerged as one of its most enthusiastic cheerleaders and he urges a federal strategy.
“I can’t tell you how many times I’d have to go into the sample drawer, because I knew if I gave a prescription to someone, they weren’t going to fill it because they couldn’t afford it,” Eric Hoskins, who’s also a physician, said in a recent interview.
A successful public health-care system isn’t just about access to a family doctor or an MRI, Hoskins says.
“It’s also about being able to access the drugs, and if there’s a barrier to that, we’re not meeting that standard of a truly public health-care system,” Hoskins said. “Pharmacare speaks to Canadian values of fairness and equity and access.”
Canada is the only industrialized nation with universal health insurance
I can’t tell you how many times I’d have to go into the sample drawer because I knew if I gave a prescription, they weren’t going to fill it because they couldn’t afford it. ERIC HOSKINS ONTARIO HEALTH MINISTER, PHYSICIAN
but no public coverage of prescription drug costs.
An estimated one in 10 Canadians can’t fill prescriptions because of the expense. The Organization for Economic Co-operation and Development has also found that Canada has the second highest per capita spending on prescription drugs in the OECD.
That’s largely because there’s no national standard for drug coverage or drug purchasing in Canada. The patchwork of provincial and territorial health-care systems means Canadians with life-threatening illnesses are confronted with costs that can vary wildly from province to province.
Even if ailing Canadians have private drug coverage, their insurers may refuse to reimburse them if the medications aren’t considered to be offering value for money. Many medications, especially so-called orphan drugs that are prescribed for rare illnesses, are exceedingly expensive in Canada.
“On pricing of medications, we pay way too much in Canada, especially for generic drugs — both public plans and private plans are paying prices that are far too high because of the way we have established how we pay for the drugs,” says Danielle Martin, a physician and vice-president of Women’s College Hospital in Toronto. Canada pays generic companies about 18 per cent of the price of the brandname drugs, whereas in other countries, generic companies are asked to bid on contracts, she says.
“And it’s amazing how the discounts start coming in. Other countries and health systems get staggeringly lower prices than we do.”
Canada also fails to buy drugs in bulk, as other OECD countries do, although the provinces and territories have started to work together on bulk purchasing, Martin says.
“Everybody knows if you buy your toilet paper in those packages of 40 rolls, you pay less per roll than if you go to the corner store and buy two rolls at a time — it works the same with medications,” she said.
But in Canada, there are many purchasers, including private employer plans, public plans and hospitals.
“If we could pool our purchasing power, and buy drugs in bulk for everyone … we could negotiate much lower prices,” she said.
“There are very solid economic estimates that suggest we could buy … a number of drugs used for chronic diseases for every Canadian who needs them for no more money than we’re currently spending.”