While common among member countries of the Organisation for Economic Co-operation and Development (OECD), Canada does not have a national pharmacare program, i.e. a single system of public insurance coverage for prescription drugs. On April 19, 2018, the Standing Committee on Health (Committee) released Pharmacare Now: Prescription Medicine Coverage for All Canadians, a report advocating the establishment of a national pharmacare program – specifically, a single payer universal publicly funded prescription drug coverage program for all Canadians, as an insured service under the Canada Health Act.

According to the report, the main purpose of a national pharmacare program would be to ensure that “no Canadian faces financial barriers in accessing medically necessary prescription drugs”. The report provides an approximate breakdown of prescription drug coverage among Canadians: 21% through provincial and territorial public plans; 3% through federally funded programs such as for First Nations and Inuit; and 70.5% through full or partial private health insurance. The report also indicates that approximately 10-20% of Canadians do not have adequate coverage.

The report makes 18 recommendations relating to:

  1. expanding the Canada Health Act to include prescription drugs dispensed outside hospitals, with costs to be shared by the federal, provincial and territorial governments,
  2. development of a common voluntary national prescription drug formulary,
  3. improving drug pricing and reimbursement processes, and
  4. improving data and information systems.

With respect to pricing, the Committee recommends that the Federal government amend the Patent Act and/or establish regulations requiring that manufacturers of patented drugs reduce their prices after 15 years if no generic substitute for a patented prescription drug is available. The Committee further recommends that the Federal Government investigate the market practices of the pharmaceutical sector, including the practices of manufacturers of patented and generic drugs, wholesalers, and retail pharmacies to identify opportunities to promote price reductions of prescription drugs through greater competition.

As we reported previously, on February 27, 2018, the federal budget announced the creation of an Advisory Council on the Implementation of National Pharmacare, which will also make recommendations on potential approaches to national pharmacare.