Pressing Health Issues in the Federal Election: Pharmacare

by Alex Kilian, Student Leadership Team Logistics and Evaluations Coordinator

THE ISSUE

The World Health Organization (WHO) has declared that all nations are obligated to ensure equitable access to necessary medicines.¹ To this goal, pharmaceutical policies should work within and be compatible with broader systems of universal health coverage.²

Spotlight on Canada: Canada is the only country with a universal heath care system that does not provide universal coverage of prescription drugs¹. Voluntary, private drug plans vary across Canada, often require out-of-pocket payments for plan deductibles and co-payments, and are dependent on income, workplace and province of residence but not on medical needs. As a result of high out-of-pocket costs, certain medications are not affordable for some Canadians, and these individuals are often forced to make the choice to decrease or forgo the use of prescribed medications. This may lead to worsening of health problems and additional costs to the health care system.

BY THE NUMBERS

• In Canada 500 million prescriptions/year, $30 billion total cost.³

The problem

• Public drug plans cover 42% of all prescription drug costs in Canada⁴
• Private drug plans cover 36% of prescription drug costs in Canada⁴
• Canadian patients pay out-of-pocket for $6 billion in prescriptions, or 22% of all prescription drug costs in Canada.⁴

The support for a solution (Based on a July 2015 poll by the Angus Reid Institute)

• 91% of Canadians support “Pharmacare” and universal access to necessary medicines⁵
• 89% believe Pharmacare should be a joint effort involving provinces and the federal government.⁵

A POTENTIAL SOLUTION

• Pharmacare: a plan that would provide safe and fair access to, and coverage for, prescription medication for Canadians, with the best economic value.

THE EVIDENCE/FEASIBILITY

Pharmacare 2020 was a report produced through collaboration with various stakeholders.⁶ This initiative aimed to promote an evidence informed dialogue on the possibility and future of prescription drug coverage in Canada. This report proposed a 25% contribution from the federal government, using funding mechanisms such as corporate taxes, income taxes, GST, and/or premiums.⁶ This federal contribution would come at no greater costs to provinces and territories and would not be redirected from other essential services. The report emphasized the need for a single payer implementation to increase purchasing power and a transparent budget to meet to goal of efficient delivery and long-term sustainability.⁶ The economic analysis indicated that a national plan could save the private sector up to $10 billion.⁶ The recent report also project decreased administration costs compared to the cost of the current financing system. With the evidence pointing to the feasibility of the project, it will certainly be exciting to watch the project unfold in the coming years, particularly with the pending status of our country’s government.

References

1. The Selection of Essential Medicines. World Health Organization. 2002. http://apps.who.int/medicinedocs/en/d/Js2296e/1.html
2. See discussion in Medicines in Health Systems: Advancing Access, Affordability and Appropriate Use. World Health Organization. 2014. http://www.who.int/alliance-hpsr/resources/FR_webfinal_v1.pdf
3. The Canadian Rx Atlas, 3rd Edition. University of British Columbia. 2013.  https://circle.ubc.ca/handle/2429/50349
4. Drug Spending in 2014. Canadian Institute for Health Information. 2014. http://www.cihi.ca/web/resource/en/nhex_2014_infosheet_en.pdf
5. Prescription drug access and affordability an issue for nearly a quarter of all Canadian households. Angus Reid Institute. 2015 http://angusreid.org/prescription-drugs-canada/
6. Morgan, S.G., D. Martin, MA Gagnon, B Mintzes, J.R. Daw, and J. Lexchin. (2015) Pharmacare 2020: The future of drug coverage in Canada. Vancouver, Pharmaceutical Policy Research Collaboration, University of British Columbia.