Research Update: Achieving Pharmacare For All
Note: this is excerpted from the December 2020 edition of our “Research Update” publication. The Edmonton Social Planning Council, in collaboration with our volunteers, strives to provide stakeholders and community members with up-to-date reviews, prepared by our volunteers, on recently published social research reports and publications.
Reviewed by Hanna Nash
Canada’s universal health care is a keystone marker of what many Canadians would identify as, in part, what makes us proud to be Canadian; a nation of those who aid and support one another in all health matters, regardless of outcome. Though our country has continued to expand services under universal health care since 1966, one area remains unincorporated. In the Advisory Council on the Implementation of National Pharmacare’s report, A Prescription for Canada – Achieving Pharmacare for All, the authors discuss how nationally implemented pharmaceutical access would benefit all Canadians and our country’s health care expenditures.
Formed in 2018, this federally appointed advisory council made significant findings and key recommendations to the federal government after studying global pharmaceutical policies and interviewing diverse groups of Canadians in all provinces and territories such as: politicians, Indigenous leaders, patients, health care providers, business owners, and academics. What is perhaps most striking among their findings is an imminent need for universal pharmaceutical accessibility in Canada—its financial impact would not only benefit individuals, but would save Canadian taxpayers significant amounts of money each year, within its first year of operation even (p. 47).
A transition phase beginning January 1, 2022 would allow the development of a Canadian drug agency to work with federal, provincial, and territorial governments to create a list of drugs that would be covered, and would continue to add recommended drugs and pharmaceuticals for a fully operational agency by January 1, 2027 (p. 78). When purchasing prescriptions drugs, Canadians would not be expected to spend more than $100.00 annually per household.
Approximately 20% of Canadians either simply cannot afford medication or do not have adequate insurance to cover their required medication (p. 113). This means that many Canadians do not take their essential prescriptions, which can cause further health complications later on, or, as in the case of one million Canadians, they must borrow money to afford the cost of their medications. What is further distressing is that Canadians who are already at a financial disadvantage are also the most impacted, and are more likely to experience ill health due to inaccessibility to medication. The elitism of pharmaceutical accessibility in Canada is felt most disproportionately by women, young people, and low-income wage earners. The end result of this disjointed and unequal approach to pharmaceuticals is that too many Canadians fall into poor health and cost Canada’s health care system billions of dollars in visits to ERs, hospitals, and physicians each year while missing work and/or school—thereby further preventing them from improving finances and health (p. 169).
The difficulty in managing Canada’s pharmaceutical costs is due to its collage of public (100) and private (100,000) drug plans that do not present significant clout when negotiating the cost of medications, as they are not unified. Among countries that offer universal health care, Canada is the only nation that does not have pharmaceuticals included under its health care plan. Additionally, the advisory council discovered that Canada pays some of the highest drug prices in the world compared to other OECD nations. The only countries that pay more for pharmaceuticals are the United States and Switzerland (p. 29).
These findings pose too great a risk for Canada’s health care to continue without putting individuals and the government into further debt. The solution to saving federal money and aiding individuals is for each province and territory to place pharmaceuticals under universal health care. This would ensure that, as a single-payer nation, Canada would have greater bargaining power against pharmaceutical companies and would, in turn, be able to negotiate better prices for all prescription drugs—including new and ground breaking treatments and formulas.
The authors tested their universal health care approach by calculating the costs of covering medications for those with diabetes, cardiovascular disease, and chronic respiratory conditions. By covering individual expenses for those particular health conditions, Canadians could conceivably save up to $1.2 billon each year (p. 47).
With these findings in mind, the authors advocate for a drug agency to push forward and come to fruition. However, one factor that must be considered is the co-operation of all provinces and territories in achieving this final stage of universal health care. If these recommendations can be fully embraced by provincial and territorial governments, the federal government could potentially see huge savings in medical costs, and a healthier, more productive, society.
Government of Canada. (2019). A prescription for Canada: Achieving pharmacare for all. Health Canada. https://www.canada.ca/en/health-canada/corporate/about-health-canada/public-engagement/external-advisory-bodies/implementation-national-pharmacare/final-report.html
ABOUT THE RESEARCH REVIEWER:
Hanna Nash enjoys ballet performances and other live theatre, as well as outdoor sports, and travelling to new countries. Hanna is interested in sharing information and knowledge to Edmonton’s diverse communities.