The War for Drugs: National Pharmacare

September 2019

Canada is the only country in the world that has universal medical care without universal prescription drug coverage. Yet prescription medications can ease pain, prevent and fight disease, and manage chronic illness. They also promote independence and lower costs elsewhere in the health care system.

When we built Medicare, health care was simpler. Illnesses were largely acute, short-term, and treated with relatively inexpensive drugs. Today, a growing proportion of health conditions are chronic and managed in the community. After physician care, prescription drugs incur the greatest costs in the system. Increasing reliance on medications, especially new biologics, parallels the world-wide spiraling of drug costs.

Let’s stop playing the blame game. Instead of blaming the ageing population, or people with disabilities or chronic conditions, or sick children, we need to change our approach.

Care Watch calls for Canada to work with provincial and territorial governments and with stakeholders to develop a pharmacare strategy and establish a universal, single-payer public pharmacare programme.

Alfred’s story

Alfred is 72. He was a labourer for various employers, so he has no employer pension. He lives on his own, but with difficulty. He’s been prescribed a large handful of pills to manage his COPD, arthritis, diabetes, and back pain. Although he’s on his province’s drugs benefits plan, the co-payment and dispensing fees eat up much of his small income. Which prescriptions can he fill? Does he need to parcel out his drugs? This year, he’s relied on food banks. If his rent is late again, he could be evicted.

What would a national pharmacare strategy involve?

Care Watch believes a national pharmacare strategy must be grounded in the Canada Health Act principles of public administration, comprehensiveness, universality, portability, and accessibility. Everyone must have access, without financial hardship, to needed medications. Canada would use its collective bargaining power to get the best deals. National pharmacare would:

  • Reduce costs to individuals, employers, and government.
  • Establish a national drug formulary to promote consistency.
  • Provide evidence-based guidance on using medications and monitor drugs for safety and effectiveness.
  • Improve access to and funding for drugs for rare diseases.

Care Watch believes our current fragmented approach is not equipped to handle the increasingly complex and expensive medications now becoming available. Its lack of fairness, accessibility, value for money, and sustainability is failing Canadians. National pharmacare would help lower costs and reduce emergency department visits, hospital admissions, and hallway medicine. It’s not a new idea, but it’s past time to act.

What can you do about a national pharmacare strategy?

First, talk to people – your family, friends, neighbours, colleagues – about a national pharmacare strategy.

Second, ask questions, lots of questions. Whenever possible, ask candidates:

  • Do you think necessary medications should be available to all Canadians, including seniors and others with limited incomes, without financial barriers? What will you do to make that happen?
  • Do you support using Canada’s economic strength to secure an adequate supply of prescription drugs and at better prices?
  • Do you support a national pharmacare strategy and programme? What will you do to make it happen?

Third, think about what you have heard, and then vote!