Pharmacare Now!: A Prescription for Equity

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Authors:

• Devon Wilton (McMaster University) 
• Michael Darcy (McMaster University)
• Connie Li (McMaster University)
• Bianca Ziegler (McMaster University)

Background: ​

• Canada remains the only high-income country with a universal healthcare system that does not include a universal drug plan.
• The current patchwork of provincial and federal regulations leaves at least 1.5 million Ontarians without any access to prescription coverage.
• Evidence shows that even a $5 charge for a prescription can lead to cost-related medication non-adherence, and that tens of thousands of Canadians experience increased morbidity and mortality each year from a lack of access to medications. 
• The federal government’s proposals and commitments to implement pharmacare date back to the 1940s, but they have failed to take definitive action. 
• In the absence of a national pharmacare plan, the provincial government is well-positioned to implement its own prescription drug coverage.  
• Drug spending is the fastest growing component of healthcare spending in Canada, rising from $2.6 billion in 1985 to $33.7 billion in 2018.
• Retail drug prices in Canada are among the highest in the OECD countries, and up to four times higher than the best available prices in the OECD.
• A national pharmacare program is estimated to save the economy between $4 billion and $11 billion per year.
• The recently-announced Confidence and Supply agreement was reported to include the implementation of pharmacare, but the fine print of the agreement actually promises very little, and the government has subsequently reversed other measures aimed to increase access to medication.

Recommendations: 

• That the federal government should move immediately to implement a national pharmacare program that is publicly administered, comprehensive, universal, portable and accessible, in line with the recommendations of the Hoskin Report.
• That the Ontario provincial government should actively collaborate with the federal government and advocate for the implementation of a national pharmacare program, and that it meets the standards of public administration, comprehensiveness, universality, portability and accessibility.
• That, in the meantime, the Ontario government should immediately reform the Ontario public drug insurance regime to ensure comprehensive, universal, and accessible coverage.
• That the Federal and Ontario provincial governments should consult with Indigenous leaders in the development of a pharmacare program, and that Indigenous communities be enabled to direct the nature of their participation in the program.
• That OMSA expand its efforts to advocate for the implementation of pharmacare in Ontario, and collaborate with the CFMS to advocate for implementation across Canada.