Pharmacare would mean big savings while closing health care gap

Posted on March 17, 2015 in Health Policy Context

TheStar.com – Opinion/Editorials – A new study on pharmacare in the Canadian Medical Association Journal makes a strong argument for universal public drug coverage: it saves money.
Mar 16 2015.   Editorial

The case for a national pharmacare program, covering prescription drug costs for all Canadians, is now noticeably stronger. A persuasive new study analyzing the cost of such coverage has found it would save a great deal of money, especially for the private sector, with relatively little expense to government.

“In many of the scenarios that we modeled, universal pharmacare was cost-neutral for governments,” said Dr. Danielle Martin, one of the study’s authors and a vice-president at Women’s College Hospital in Toronto. “This goes against current thinking that a universal program will cost more.”

These findings, published on Monday in the Canadian Medical Association Journal, should be required reading for provincial and territorial politicians and especially in Ottawa, where federal determination to make pharmacare happen has been noticeably lacking.

Universal public drug coverage could lower annual spending on prescription medicine in Canada by $7.3 billion, conclude the study’s authors. Several scenarios were developed on what such a program might cost government, with the worst-case estimate pegging additional costs at $5.4 billion and the best-case scenario producing a net saving of $2.9 billion.

Under a mid-range “base scenario,” total cost to governments would be $958 million. But that would generate an $8.2-billion drop in private-sector spending on prescription drugs. It’s an investment well worth making.

Savings of this magnitude would put Canadian per capita prescription drug spending on par with levels in countries such as Switzerland, Austria and Spain, note the authors. (Nations such as the United Kingdom, New Zealand and Sweden spend even less.)

Canadians currently shell out an average of 50 per cent more, per capita, than people in other developed countries. And it’s no coincidence that Canada is alone in having a universal health insurance system that does not include the cost of prescription drugs.

Instead, what we have in this country is a mishmash of private drug plans — with access typically depending on where a person works — and a patchwork of federal and provincial systems, typically serving groups deemed to be in need, such as the elderly and welfare recipients. Their prescriptions are already funded by taxpayers.

It’s a woefully inadequate system that leaves many Canadians with no drug coverage at all, especially the young, the self-employed and people working for small businesses that can’t afford to provide a drug plan. As a result, millions of Canadians lack money to buy the medicines they need.

A national pharmacare program would unite the country’s purchasing power and use economies of scale to help negotiate lower prices for both generic and brand-name drugs. That’s the main way other countries have managed to control expenditure.

There would be a modest increase in one cost category: uninsured people who can’t afford medicine will finally fill the prescriptions they’ve been given. But there would be additional savings, too, by eliminating the duplication of legal, technical and administrative work inherent in Canada’s existing, disjointed approach. The net result would be a far more cost-effective system.

But the goal of national pharmacare isn’t just to save money. Prescription medication can keep people healthy, ease pain, avoid trips to the hospital, and even save lives.

Pharmacare is ultimately about giving all Canadians access to the medicines they need — regardless of where they work, the province where they live, their age, their medical condition or whether they’re on welfare. It’s about closing a disgraceful gap in our universal health-care system.

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