Introduction

Unlike many Organisation for Economic Cooperation and Development member countries, Canada has no national pharmacare programme (ie, a single system of public insurance coverage for prescription drugs). However, on April 19 2018 the Standing Committee on Health released Pharmacare Now: Prescription Medicine Coverage for All Canadians, a report advocating the establishment of a national pharmacare programme – specifically, a single-payer, universal, publicly funded prescription drug coverage programme for all Canadians – as an insured service under the Health Act.

Recommendations

According to the report, the main purpose of a national pharmacare programme would be to ensure that "no Canadian faces financial barriers in accessing medically necessary prescription drugs". The report provides the following approximate breakdown of prescription drug coverage among Canadians:

  • 21% through provincial and territorial public plans;
  • 3% through federally funded programmes, such as First Nations and Inuit programmes; and
  • 70.5% through full or partial private health insurance.

The report also indicates that approximately 10% to 20% of Canadians have inadequate coverage.

The report makes 18 recommendations concerning:

  • the expansion of the Health Act to include prescription drugs dispensed outside hospitals, with costs to be shared by the federal, provincial and territorial governments;
  • the development of a common voluntary national prescription drug formulary;
  • improved drug pricing and reimbursement processes; and
  • improved data and information systems.

With respect to pricing, the committee has recommended that the federal government amend the Patent Act and/or establish regulations requiring manufacturers of patented drugs to reduce their prices after 15 years if no generic substitute for a patented prescription drug is available. The committee has further recommended 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 – in order to identify opportunities to promote price reductions of prescription drugs through greater competition.

Advisory council

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 (for further details please see "Federal Budget 2018 announces advisory council for national pharmacare programme").

For further information on this topic please contact Abigail Smith at Smart & Biggar/Fetherstonhaugh by telephone (+1 416 593 5514) or email (aesmith@smart-biggar.ca). The Smart & Biggar website can be accessed at www.smart-biggar.ca.

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