Trudeau government unveils national pharmacare bill

Posted on February 29, 2024 in Health Policy Context

Source: — Authors: , – Politics/Federal,
February 29, 2024.   By Raisa Patel, Ottawa Bureau, Tonda MacCharles, Ottawa Bureau Chief

Health Minister Mark Holland has unveiled the Liberal government’s plan to kick-start a national pharmacare program, introducing a bill that spells out a single-payer plan to cover prescription drugs and related medical equipment for diabetes and birth control.

OTTAWA — Health Minister Mark Holland has unveiled the Liberal government’s plan to kick-start a national pharmacare program that aims to first cover diabetes and birth control drugs and devices, and launches talks toward a universal government-paid drug coverage plan as long as provinces go along with it.

The plan outlined in proposed legislation came with no price attached and the government says no overall spending will be booked in this year’s budget, but Holland said a ballpark figure for its first phase could be $1.5 billion.

Holland introduced a short bill in Parliament Thursday that sets out steps to create the broader plan, all of which will depend on provincial governments’ agreement, explaining that Ottawa chose to go first with contraception and diabetes medication coverage to address “accessibility and affordability” for millions of Canadians.

Access to affordable contraception for about nine million Canadian women who should be able to control their reproductive health is “an absolutely critical part of having a just society,” he said. “This is about health equity.”

Diabetes was targeted because it affects 3.7 million Canadians at tremendous cost, he said.

The legislation would provide for payments to any province or territory to cover or increase existing public pharmacare coverage for those drugs, and says the government will name a committee of experts within a month after the bill is passed to recommend “options for the operation and financing of national, universal, single-payer pharmacare” within one year.

Covering just two drugs at the outset will allow the federal government to assess how the plan is working, including any actual savings through bulk purchasing, Holland said. “You do a little bit and you evaluate and you learn, and you use that evaluation and science to inform your next step.”

In introducing the legislation, Holland fulfilled a central pledge of the Liberals’ parliamentary alliance with the NDP, which sees the New Democrats prop up Justin Trudeau’s minority government in exchange for action on shared priorities.

NDP Leader Jagmeet Singh took credit for forcing the Liberals to act, saying the government would not have honoured its long-standing promises to establish pharmacare without his party’s pressure. Come election time, he said, “people will have a choice.”

“If you want to see more pharmacare you’re going to need New Democrats. It’s not gonna be Liberals that deliver more of this,” Singh said.

The federal government says most drug plans already list contraceptives, but only a fraction of Canadians are eligible for prescription birth control at low or no cost through public drug plans. If they do not have coverage through a private health plan, Canadians typically have access to only public safety net coverage that is intended to protect residents from very high drug costs, which often carry high deductibles and co-payments.

The federal plan would cover oral contraceptives, copper intrauterine devices (IUDs), hormonal IUDs, contraceptive injections, hormonal implants, vaginal rings and with morning-after pills.

Oral contraceptives cost about $300 a year, while IUDs, which are effective for five years, cost up to approximately $500, according to the federal government.

As for diabetes drug and device coverage, the plan is to cover insulin and medications like metformin, equipment to monitor sugar levels like glucometers, test strips and lancets, as well as flash and continuous glucose monitoring devices.

Insulin can cost $900 to $1,700 per year, depending on the type and dosage required. Other medications can cost $100 to more than $1,000 per year, according to the government.

All provinces and territories already offer some form of coverage or financial assistance for diabetes-related medical devices and supplies but the programs vary in terms of the support provided and eligibility.

Diabetes is more common in people of First Nations and Métis descent as well as those that are African, South Asian and East Asian descent, said a government official at a background briefing, “and again, the cost is often borne by those people more than others.”

Ontario Health Minister Sylvia Jones said the province is “waiting for details” about how a national pharmacare program would work.

“We have OHIP+, so we have a pretty robust system, particularly on the diabetes side with the assistive devices program,” said Jones, referring to the provincial pharmacare system that provides more than 5,000 medications to people 24 years or younger who are not covered by a private benefits plan.

“So we need to see and assess what the federal government is proposing and how it matches or conflicts with the existing system that is already here,” she said.

“I was very clear with the minister when we spoke that I’m not writing off anything, but I’m also not buying into something where I don’t know exactly what’s there and the assessment truly has to happen. I want to make sure that those very valuable programs can continue in Ontario.”

Earlier this week, Alberta Health Minister Adriana LaGrange rejected the yet-to-be-released plan, arguing that her province had not been consulted. Quebec has also signalled it wants Ottawa to stay out of its drug coverage system.

Holland said he is in talks with LaGrange, and “that conversation leads me to believe we can find answers, we can find solutions.” B.C. and Newfoundland and Labrador have already shown they are “extremely interested” in the plan, he added.

Singh turned aside concerns that provinces like Alberta may not join the program, or that Quebec — which has its own public drug plan — might opt-out, predicting that other provinces will soon sign on.

Conservative Leader Poilievre said he would wait to see if the pharmacare program actually gets off the ground and leads to savings for Canadians and the government, noting housing promises by the Liberal government have failed to deliver as promised.

Poilievre said Quebec should have a right to opt out while still receiving its share of the funds under the program.

Singh also backed Quebec’s opt-out right, but said Quebecers should have the same access to drugs like contraceptives. “Our position is people in Quebec should not be getting any less coverage than people anywhere else across the country. We want to see free birth control for everyone in our country,” Singh said.

With files from Robert Benzie

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