It’s time for a universal pharmacare system
TherStar.com – Opinion/Commentary – Canada is the only developed nation with universal health-care but no corresponding coverage for prescription drugs.
Dec 11 2014. By: Vivian Tam
Thirty years ago, the federal government adopted the Canada Health Act to ensure that all Canadians would have access to universal health-care. While we’ve achieved coverage of hospital and medical services, we remain the only developed nation in the world with universal health-care but no corresponding pharmaceutical coverage – as if access to medicines were not an integral part of health.
This past weekend, 70 of my fellow medical students and I converged on Parliament Hill to seek political support for universal pharmacare, a system that can correct many of the financial and health inequities that exist as a consequence of our fractured drug coverage model.
Specifically, we asked that the government convene a task force or special committee to review the current state of pharmaceutical coverage in Canada, and outline steps towards implementing universal pharmacare. These moderate steps are instrumental to the design of a comprehensive and universal drug coverage system.
While the development of universal pharmacare will require significant further study and stakeholder engagement, we are not alone in our vision. The Institute for Research on Public Policy and Canadian Doctors for Medicare both released reports recently underlining the necessity of introducing pharmacare in Canada. The need for universal drug coverage has also steadily gained political traction, emerging as a topic of discussion at the meeting of provincial and territorial health ministers in October. Canadians are increasingly demanding universal pharmacare – and with good reason.
Evidence increasingly suggests that Canada can’t afford not to have pharmacare. Every year, Canadian prescription drug costs increase faster than that of all other OECD countries. Of immediate concern is that over one-fifth of these rising costs are borne out-of-pocket by households without private insurance, leaving 8 million Canadians with insufficient access to medicines.
Affected individuals cannot afford their prescriptions, resorting to rationing, or worse, not taking any medicine at all. Patients without access to front-line drugs have a high likelihood of re-entering the health system via acute care, posing a larger financial and health system burden than if they could access the treatments they needed to begin with.
Canada’s lack of universal drug coverage also exacerbates inequities between provinces. As drug prices are negotiated individually between the provinces and drug companies, many smaller provinces are left to pay significantly more than others for the same drug. Consequently, the percentage of households spending over 5 per cent of their income on prescription drugs varies widely, ranging from 2.2 per cent in Ontario to 10.1 per cent in P.E.I.
The federal government has a significant role to play in mitigating these health and financial inequities, no less because of its unique ability to negotiate lower drug prices on behalf of the nation as a whole. We have seen significant gains already with the Pan-Canadian Pricing Alliance, a collaborative bulk-purchasing initiative spearheaded by provinces to achieve the most economical drug costs. To date, agreements have been reached on more than 40 drugs, yielding $260 million in savings. Unfortunately, outpatient medication is only partially publicly funded, and both private insurers and uninsured households will not benefit without federal involvement.
While health care is commonly seen as a provincial responsibility, involvement of the federal government would be crucial to implementing universal pharmacare. Ottawa is able to negotiate drug prices on behalf of all Canadians – allowing for a bulk bargaining strategy that can significantly reduce pharmaceutical costs and inequities between provinces.
Universal pharmacare only seems to make sense from an access, equity, economic and constitutional perspective. As Canada’s future physicians, we believe that individuals deserve the right to access medications based on need, not on where they live or their financial means. Canada is a country that prides itself on providing universal health care to all its citizens, and it is past time to include drug coverage – a fundamental component of effective medical treatment – in a truly comprehensive and accessible health-care system.
Vivian Tam is a first-year medical student at McMaster University, writing on behalf of the Canadian Federation of Medical Students.
< http://www.thestar.com/opinion/commentary/2014/12/11/its_time_for_a_universal_pharmacare_system.html >
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