We can’t wait for a national pharmacare plan

Posted on May 7, 2022 in Health Debates

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TheStar.com – Opinion
Fri., May 6, 2022.   By Jane Philpott, Danielle Martin, Contributors

The proposed timeline is not fast enough for Canadians unable to pay for medicines that should be part of any rationally designed health-care system.

The Canadian rallying cry for universal drug coverage — “pharmacare now” — needs a shot of adrenalin: “pharmacare … immediately.”

In the midst of the health crisis of our generation, Canadians should be appalled by how much time is spent every day by doctors, nurses, pharmacists and others working around our nonsystem of drug coverage in Canada.

As medical educators, we teach new physicians to ask if the patient has insurance; to call local pharmacies to do a price comparison; to ask whether people are splitting pills, or skipping them to save money; to negotiate “compassionate access” with pharmaceutical companies; and the list goes on.

At a time when hospitals are over capacity (again) and struggling with staff shortages, wouldn’t it be better if people could manage their chronic diseases at home, rather than ending up in emergency departments with preventable complications because they couldn’t afford their meds?

In a 2020 study, nearly one-quarter of Canadians reported not filling a prescription due to cost. Amid pandemic uncertainties, 14 per cent reported having lost prescription drug coverage. Women, racialized people, and low- and middle-income households were least likely to have adequate coverage, and more likely to not fill their prescriptions.

As the gig economy and contract work grow all around us, workers are even less likely to have access to prescription medications, with a disproportionate impact on young people, newcomers and racialized individuals.

Canadians need access to necessary medicines and protection against related financial strain. Luckily, bulk buying power means a universal, public drug plan can not only meet those needs, but can also save Canada $5 billion per year.

In medical schools across Canada, we teach learners to make prescribing decisions based on scientific evidence. This includes avoiding potentially inappropriate prescribing, especially for older people. It includes prescribing cost-effective options. It includes watching for side effects and monitoring for rare adverse reactions to drugs. A well-designed pharmacare program would help to support all these goals, encouraging high-quality prescribing in ways that a patchwork of private plans will never do.

The critical need to provide all Canadians with access to necessary medicines based on the best evidence is why five separate commissions have called for a national pharmacare program. It is also likely why nine in 10 Canadians support implementation of universal, public pharmacare now. We can assure you that the exhausted doctors, nurses and other health professionals of the country agree.

That’s why we added our names to a letter signed this week by over 1,000 health professionals and experts. It calls for advancing the timing and scope of Canada’s plans — starting with universal, public coverage of essential medications before the end of 2022.

The federal government has promised to pass a Canada Pharmacare Act in 2023 and to work toward providing universal coverage of essential medicines by 2025. That’s progress, but the timeline is not fast enough for Canadians unable to pay for medicines that should be part of any rationally designed health-care system.

Luckily, we are not starting from scratch. Work is already underway on developing the principles for and content of an essential medicines list for Canada. Many of these medicines are commonly prescribed for conditions like high blood pressure, depression, diabetes, asthma and more. In fact, the proposed list of essential medicines for Canada would cover nearly half of all prescriptions written here.

Canadian research has shown that providing essential medicines at no cost to patients will improve access to medicines and help families make ends meet. Such access also reduces the costs associated with hospitalization and emergency room visits. That is a crucial benefit at a time when our health system is already overstrained.

What we can’t do is wait. The federal government’s Advisory Council on the Implementation of National Pharmacare recommended essential medicine coverage start in 2022, and provided details on how to do this. Executing that vision immediately would help countless Canadians now, and lay the foundation for a more comprehensive system of public drug coverage to follow.

Canadians and the health-care workers who serve them desire — and deserve — a health-care system that does not abandon patients the moment they receive a prescription. The time for commissions, studies and reports must be behind us. When it comes to national pharmacare, there is no time like the present.

Jane Philpott is a family physician and dean of the Faculty of Health Sciences at Queen’s University. Danielle Martin is a family physician and chair of Family and Community Medicine, Temerty Faculty of Medicine at the University of Toronto.


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