A recent CBC the fifth estate report featured the current high cost of prescription drugs in Canada. A growing number of advocates (including CARP) would like to see a national drug program become a reality.

Canada is the only country in the world that has a universal health care system that doesn’t include universal drug coverage. We are among the highest spenders in the OECD.

Related: The high costs of health care

the fifth estate documented how New Zealand negotiates brand name drug prices that are about 40% lower, and generic drug prices that are 90% lower than Canadian prices because they buy medications as a country, negotiating pricing and ensuring stable supplies.

Prescription drug coverage in Canada varies widely depending on where you live, your health status, your income, and your age. Right now, each province has its own pharmacare program and there is no consistency. A universal prescription drug plan could not only reduce total spending, it would also cover everyone at an affordable price.

Universal National Drug Program in Canada

Prescriptions have become unaffordable for some

The Canadian Medical Association states that 10% of Canadians say they can’t afford to take their medications as prescribed. They are splitting their pills, cutting back on prescriptions, and many even stop taking them entirely because of the cost.

This ends up costing the country in the long run.

Studies in the U.S. suggest that providing prescription medications for free increases the chance that patients will actually take their meds as prescribed, which in the long run improves health and reduces demand on the health care system.

So, what’s the delay?

A national pharmacare program was originally recommended in 1964 – two years before the national Medical Care Act was adopted. It was brought up again in the 2002 Romanow Commission on how to modernize health coverage.

Why hasn’t it been implemented yet?

The main arguments against a universal drug program are:

  • Most Canadians have health insurance privately or through their employer.
  • A lot of provinces have legislation to cover the poor and the elderly.
  • None of us want to pay more taxes.
  • It’s just not affordable.

But, according to the Canadian Medical Association, the total cost of a national pharmacare program would actually be less than what is currently being spent by public and private drug plans and patient payments combined.

To make a universal national drug program, Canada would have to decide exactly how the coverage would work.

  • How much would we pay (based on negotiations with the manufacturers)?
  • What drugs would be covered?
  • What percentage of the cost would be borne by the government?
  • Will the cost of pharmaceuticals come out of the overall health care budget?

Perhaps that’s why it’s not officially on the federal government’s agenda of priorities.

Final thoughts

Canada currently has one of the most expensive systems for purchasing prescription drugs in the world. A better deal could be made with a bulk purchasing system instead of every province buying drugs for their plans separately.

It would mean leveraging our buying power to help contain drug costs, ensure stable supplies, and improve the future health outcome of our population.

The sustainability of our health care system may depend on it.


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